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We take a break from the ‘Story of a Pharma Salesperson’ and move on to other topics. We shall return to it later.
‘Health For All’ slogan has been around since long, and repeated by successive governments.
We don’t know what exactly was intended by this slogan but all along we have been assuming it would mean Health Cover for everyone. It never materialized though.
Government does have a large network of medical facilities where patients are treated for illnesses ranging from small problems to serious ones. Four levels of medical care are organized by the government. The Basic Health Units (BHUs) provide primary care, which means simple, uncomplicated, ambulant patients not requiring round-the-clock care. Then there are District Head Quarters (DHQ) Hospitals where several specialties are available along with in-patient facility. The number of specialties is limited, and more complex cases cannot be treated there and must be referred. Then there are teaching hospitals in larger cities which strive to treat all kind of ailments. These are Tertiary Care hospitals. Fourth level is specialized institutes like Institutes of Cardiology, Kidney transplant, liver transplant and so on. These are also Tertiary Care places but focused on a specific disease area.
Government spends billions of rupees every year for maintaining healthcare hardware set up. Many more billions are spent on purchasing medicines for all levels of hospitals. We do not need to go into the details of this process. It is enough to know that over 400 billion are allocated for healthcare sector at the federal level. After 18th amendment, healthcare has become provincial subject.
Is this budget enough for the entire population? Of course not. Per capita spending is too small to cater to medical needs of people.
For this reason, medical care in Pakistan is a private affair. We have to spend from out of pocket to get treatment for ourselves. The government hospitals are severely deficient and therefore people are forced to go to private hospitals.
It is reasonable to understand that owing to our economic status, the government shall not be able to provide free or state-sponsored treatment. It may however be possible to regulate private healthcare in order to facilitate common public.
Private healthcare in Pakistan has thrived in a way where few businesses would compete with it. This is evident from the mushroom growth of private clinics, hospitals and even medical colleges. The quality and affordability of private medical treatment keeps raising serious questions, but this is not our topic today.
The largest majority in Pakistan do not keep a budget for health in their home budget. Whenever a health issue arises for any family member, it is taken care of on emergency basis. Money shall be diverted from various sources to fulfill the medical needs which sometimes become enormous and impossible to manage.
Multinational companies and larger corporates buy medical insurance for their staff. The extent of coverage varies with premium and seniority.
Personal buying of medical insurance is the most neglected area. Very few, if any, families buy medical insurance though it can be very helpful. The cost is flexible, but the benefits can be significant. The Medical Insurance can be particularly helpful in the event when an emergency arises.
It is strange that neither insurance companies nor media promote medical insurance. The present ‘Insaf Card’ or ‘Sehat Sahulat Card’ scheme of PTI government is also based on insurance. Government shall pay premium to insurance company and they will pay for the medical expenses.
There is one observation about medical insurance and other insurances like car insurance. Every time the insurance is used, it becomes a source of making extra money for the insurance claim handling people and the service provider. The billing is exorbitant, unnecessary items are added and quality of service is inferior. This area also need attention.
Healthcare in Pakistan is mostly catered through private sector because government fails to provide this basic need. People are forced to go to private consultants, labs and hospitals. While government cannot ensure healthcare for all, but it can facilitate general public through awareness of alternatives, such as medical insurance.