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Health Insurance Reform Suggestion Committee Report Published

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Kathmandu. The Health Insurance Reform Recommendation Task Force Report 2081 has been made public. The report has submitted suggestions in various formats including immediate, short-term, medium-term and long-term.

The report was made public at a press conference organized at the Ministry of Health and Population today in the presence of Minister for Health and Population Pradeep Poudel, Secretaries Dr. Bikash Devkota and Hari Prasad Mainali, Executive Director of the Health Insurance Board Dr. Raghunath Kafle, among others.

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The suggestions focused on increasing the effectiveness of health insurance and making it accessible to all citizens, making the services available through insurance quality and accessible to all, maintaining good governance in health insurance, making health insurance self-reliant, and operating health service programs through insurance in an integrated manner in the country. .

A nine-member Health Insurance Reform Suggestion Committee was formed under the leadership of Dr. Shambhu Acharya on Asoj 13. The committee submitted its report to Health Minister Pradeep Poudel on Poush 19.

Releasing the report, Health Minister Poudel said that it is the government’s priority to systematize and continue health insurance. He said, “Now, it will be mandatory to have a unit to provide health insurance at every level. Health insurance belongs to all three governments.” The money spent by all three governments needs to be used to strengthen the insurance fund.’

Minister Poudel informed that the current health insurance fund could be strengthened if arrangements were made to directly transfer only a small portion of the taxes imposed on sugary products that have a greater impact on the health of citizens and taxes imposed on pollution, tobacco, alcohol, etc. that have an adverse effect on health to the health insurance fund.

Since the current benefit package is not enough to cover the cost of a fatal disease, it has been suggested that the benefit package should be increased to at least five hundred thousand by arranging premiums and co-payments based on the ability of the person to pay.

The report recommends that the health insurance fund be increased to at least five hundred thousand by making the free basic health service and emergency service guaranteed by the constitution more effective. It has been suggested that the service package and premium be designed so that additional physical facilities can be availed while maintaining the same clinical service and being affiliated with the insurance.

Also, it has been said that the board should prepare a package to determine additional premiums for those who want to avail additional physical facilities, and the service provider ministry and the board should formulate and implement standards to manage the remittance.

It has been suggested that the organizational structure of the Health Insurance Board be approved, the basic health service package be reviewed and implemented, and old outstanding payments be made and made available. Similarly, it has been suggested to restructure and rename the health insurance, make the board fully automated through the use of modern information systems, and expand the scope of the benefit package.

It has been said to integrate the health-related programs of the three levels of government by making a law, make the premium progressive and increase it from 7,000 to 15,000, provide full subsidies to the poor and targeted, and bring all government employees and formal sector employees under the scope of health insurance.

It has been said to make health insurance compulsory for the general public and to make government employees and organized sector workers affiliated with health insurance by getting a decision from the government.

The committee has said to provide insurance to 100 percent of citizens by 2091 BS. It has also given suggestions along with a proposed 10-year target to bring it within the scope. As mentioned in the report, in the current year, 39 percent of households and 25 percent of the population across the country are covered by insurance, and the target is to cover 100 percent of households and 90 to 100 percent of the population with health insurance by 2091 BS.

 

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