Govt's health insurance plan for all makes feeble start

October 27, 2016 00:50 AM Bishnu Prasad Aryal


Only 18,000 sign up, 2,200 get insurance compensation in three months
KATHMANDU, Oct 26: The government's plan to provide health insurance for all the people within three years is off to a feeble start. 

According to the Ministry of Health (MoH), the government's plan is to provide insurance cover to the total population of about 28 million in all the 75 districts within a period of three years, extending the scheme to 25 districts each successive year. It has earmarked Rs 2.5 billion to provide insurance to the people of 25 districts in the current fiscal year.

MoH began its health insurance scheme targeting the 1.3 million people in Baglung, Kailali and Ilam districts, from mid-July. However, only 18,000 people in the three districts registered their names in the last three months. “A total of 2,200 people received insurance compensation during this period,” said Dr Guna Raj Lohani, chief of the insurance program at MoH.

The government has made health insurance premiums of up to Rs 50,000 per family tax-exempt. Each local body has been assigned a registration team which visits people door-to-door. “If any one wishes to get registered, they can contact the registration facilitator any time,” said Dr Lohani. “They will then be issued identity cards.” 

“A five-member family will have to pay the government Rs 2,500 annually as insurance premium. If there are more members in a family, they will have to pay Rs 425 for each additional member,” said Dr Lohani.

People will  be able to get the services of government hospitals upon presentation of their identity cards and the hospitals will be reimbursed by the government. Private hospitals will be kept on referral lists for upcoming programs, according to MoH.

In its budget for fiscal year 2016/17, the government announced the implementation of a 'National Health Insurance Scheme' in a phase-wise manner.  

Health Minister Gagan Kumar Thapa, speaking at a public function recently, also pledged to provide health insurance to every individual in the country. However, the government has not made any significant effort to raise awareness about the benefits of insurance.

“The participation of people in the program is unexpectedly low and we need to work on this,” said Dr Lohani at MoH.

The government will gradually extend the program to five more districts every three months, it is also learnt. The districts selected for the scheme in the current fiscal year are Baitadi, Achham, Myagdi, Palpa, Kaski, Jhapa, Tanahu, Gorkha, Bhaktapur, Chitwan, Jumla, Jajarkot, Mahottari, Dolpa, Makwanpur, Solukhumbu, Surkhet, Bardiya, Parsa, Sindhuli, Sunsari and Rautahat. 

Meanwhile, private insurance companies have been selling policies worth Rs 200,000 to Rs 1 million.

 But these companies expect a negligible rise in the number of policy buyers as it will take time for the public to learn about the benefits of insurance.

Insurance policies and premiums vary from company to company. Policy buyers can get health services at different hospitals, and insurance companies have also tied up with Indian hospitals. 

According to the Beema Samiti, the insurance market regulator, insurance schemes will be more effective if they come under the purview of the Samiti.

Though insurance companies in Nepal readily provide their services, people rarely insure themselves against medical contingencies.

At present, single individuals have to pay tax on incomes above Rs 250,000 and families for above Rs 300,000.

The government has scrapped taxes on insurance compensation, including compensation paid to the family of a deceased person.

Districts selected for health insurance programs this year
Phase    Districts    
I           Baglung, Kailali, Ilam (Executed)    
II           Baitadi, Achham, Myagdi, Palpa, Kaski (Ongoing)    
III           Jhapa, Tanahu, Gorkha, Bhaktapur, Chitwan    
IV          Jumla, Jajarkot, Mahottari, Dolpa, Makwanpur    
V           Solukhumbu, Surkhet, Bardiya, Parsa, Sindhuli    
VI          Sunsari, Rautahat    


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