Every year, 21 billion rupees are spent twice in the state under the social health security program under various titles run by the Ministry of Health and Population. According to the 2081 report of the Health Insurance Reform Suggestion Working Group, under the Social Health Security Program, one person is receiving double-triple benefits.

Executive Director of Health Insurance Board Dr. According to Raghuraj Kafle, out of the estimated 41 billion rupees spent under various healthcare programs, it seems that about 21 billion rupees are being spent twice. "A single person with access has taken free services provided through the social service unit of the health insurance board, association, state, local level and hospital. Also, they are taking health services from social security fund, savings fund, citizen investment fund, etc., he said.

According to the 2081 report of the Health Insurance Reform Suggestion Task Force, under the Ministry of Health, under the Ministry of Health, under the social health security program, drug treatment for poor citizens, mother protection, free heart treatment for children under 15 years and senior citizens above 70 years of age, and free treatment for serious diseases for poor citizens are in operation . The state spends 12 billion rupees every year on these programs.

About one billion rupees are spent on health aid from the local level, about 2 billion rupees are spent on free treatment given through the social service unit of the hospital on the recommendation of the ward, and about one billion rupees are spent on health aid and subsidies from the local level. According to the report, the seven provincial governments have been providing about 5 billion rupees in health subsidies every year.

Similarly, one and a half billion rupees are spent on drug treatment through the Social Security Fund operated under the Ministry of Labour, Employment and Social Security. Nepalese army and their families are provided free treatment through the Military Welfare Fund under the Ministry of Defense, Police and their families through the Police Welfare Fund of the Ministry of Home Affairs. Also, under the Ministry of Federal Affairs and General Administration, the Civil Hospital has arranged a 40 percent discount on treatment for officer-level employees and their families, and 50 percent discount for those below the official level and retired and their families. Apart from these, the Employees' Provident Fund under the Ministry of Finance, Citizen Investment Fund, various banks have coordinated with the insurance company and given certain amount to the account holder for treatment .

Through these scattered social health security programs, the state's huge amount of money is being spent twice. In last year's policy and program, the Ministry of Health said that the Social Health Security Program under the Ministry will be integrated and operated through the Health Insurance Board to prevent double spending in the health sector.

In 2076, it was discussed to run the health program of the Social Security Fund under the Ministry of Labour, Employment and Social Security through the Insurance Board. Health Minister Pradeep Paudel had announced in July 2081 to integrate the social health security program and to increase the insurance amount from 2 lakh rupees to 5 lakh rupees. However, even the health programs run under the Ministry of Health have not been able to be conducted through the one-door system, let alone the social health security programs run under other ministries.

Dr. Senendraraj Upreti, the former chairman of the Health Insurance Board, said that due to the lack of coordination of the Ministry of Health, social health protection programs could not be conducted through a one-door system. The act and scheme of the social health security program is different from ministry to ministry. A lot of coordination is needed to create a unified standard," he said.

Insurer Dr. Suresh Tiwari said that the report of the Health Insurance Reform Suggestion Task Force should be implemented rather than a speech. "The task force report mentions which section of the law related to the social security program will be amended by which agency," he said.

The Ministry of Health has asked the Ministry of Finance to coordinate the social security program under the Ministry of Health through the Insurance Board from July 1.

Health Minister Pradeep Paudel expressed his belief that the Minister of Finance is positive about this matter and that the social security program under the Ministry of Health will be operated through insurance from the next financial year. "If the scattered social health security programs are conducted through a one-door system, the service facilities of the patients will not be reduced, but will be increased," he claimed, "discussions are being made to integrate the social health security programs under other ministries."

The spokesperson of the Ministry of Finance, Shyam Prasad Bhandari, said that the Coordination Branch is discussing with the relevant agencies about integrating the social security program under the Ministry of Health. "We are also discussing with the Finance Minister how to implement it in the next budget," he said, "We will reach one or the other conclusion." Likewise, Krishna Adhikari, the spokesperson of the Social Security Fund under the Ministry of Labor, said that if the state wants to, the scattered social health security programs can be integrated and put into operation.

"The fund has no objection to running the health program of the Social Security Fund through the insurance board," he said, "but whether the health insurance board can handle it or not." It is also important to study about this.''

board now has 40,000 requests for payment every day. However, only 7,000 claims have been reviewed. The number of claims will double if the scattered social health security program is implemented. There is also a question whether the current manpower and technology can handle the board at that time. According to the white paper issued by the Health Insurance Board in March 2081, 16 billion 45 million payments are due by the end of February 2081/82. It seems that this amount will increase to 24 billion by the middle of the current financial year. However, there is only one billion rupees in the fund of the board.

Health Minister Paudel said that not only the one-door system of social health security programs will be implemented, but preparations are being made to conduct an organization and management survey (O&M) for the required manpower. According to insurance experts, if social health protection programs can be conducted through a one-door system, not only will double spending in the health sector of the state end, but administration and staff costs will also be reduced. 

Dr. Tiwari, an insurance expert, said that if a unified system is implemented, it will be easier to provide quality services and monitor irregularities in the health sector. The amount of the insurance fund will also increase. It also helps to increase the service facilities of the insured, to increase the number of insured," he said, "The biggest thing is to increase trust in the insurance board. Common people will have access to health services.

At present, only the poor, the poor, those with chronic and severe diseases are included in the insurance program. Affluent families are less involved. If the social security program is conducted through the insurance board, the well-off family must also be included in the insurance. It will also play an important role in achieving the Sustainable Development Goals by 2030 through the Insurance Board's for-profit health insurance program. According to insurance expert Dr. Tiwari, the insurance program will also help to eliminate poverty.

According to the report on the progress of universal health access and health-related sustainable development goals in the South-East Asia region-2021, published by the World Health Organization, about 500,000 people in Nepal are pushed below the poverty line every year due to personal expenses on medical treatment.