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The report of the Health Insurance Reform Recommendation Task Force 2081 has been published. Through the report, the working group has submitted suggestions in various formats such as immediate, short-term, medium-term and long-term.
The report was made public in the presence of Health and Population Minister Pradeep Paudel, Deputy Secretaries Dr Vikas Devkota and Hariprasad Mainali, Executive Director of Health Insurance Board Dr Raghunath Kafle and others at a press conference held at the Ministry of Health and Population today.
It has been suggested to increase the effectiveness of health insurance and make it accessible to all citizens, to make the services available through insurance high-quality and accessible, to maintain good governance in health insurance, to make health insurance independent and to conduct health service programs through insurance in an integrated manner in the country.
On October 13, a nine-member health insurance reform suggestion committee was formed under the leadership of Dr. Shambhu Acharya. The committee submitted a report to Health Minister Pradeep Paudel on January 19. Releasing the
report, Health Minister Paudel said that health insurance is a priority of the government as it is being tried to organize and continue. He said, 'Now it will be mandatory to have a health insurance unit at every level. Health insurance is from all three governments. It is necessary to use the money spent by all three governments to strengthen the insurance fund.'
Minister Paudel said that if a tax on sugary products that affect the health of citizens and a small portion of the tax on pollution, tobacco, alcohol, etc. that have an adverse effect on health can be arranged to go directly to the health insurance fund, the current health insurance fund can be strengthened.
In the case of a fatal disease, the current facility bag is not sufficient to pay for it, so he suggested that the facility bag should be at least 500,000 by arranging premiums and co-payments based on the person's ability to pay. In the
report, it has been suggested that the free basic health services and emergency services guaranteed by the constitution should be linked with health insurance to make them more effective, and the service package and premiums should be designed in such a way that clinical services remain the same and more physical facilities can be taken.
In addition, it is said that for those who want to get additional physical facilities, the board will prepare a package by determining the additional premium and the service provider ministry and the board will make and implement standards to organize the remittance.
It has been suggested to approve the organization structure of the health insurance board, review and implement the basic health service package, and pay the old balance. Likewise, the restructuring and naming of health insurance, making the board fully automated through the use of modern information systems, and widening the scope of the facility have been suggested.
It is said to integrate the health related programs of the three levels of the government by making a law, make the premium progressive from 7000 to 15000, give full subsidy to the poor and targeted, bring all government employees and formal sector employees into the scope of health insurance .
It has been said that public health insurance will be mandatory and government employees and organized sector workers will be included in health insurance as decided by the government. The
committee has also suggested a 10-year proposed target to bring 100 percent of the citizens under insurance by 2091. According to the report, in the current year, 39 percent of households and 25 percent of the population are covered by insurance, and in 2091, 100 percent of households and 90 to 100 percent of the population are covered by health insurance.
