The problem of not getting medicines at a discount for the insured members of government health institutions still persists. Nine years after the implementation of the health insurance program, the insured still has to buy expensive medicines from private pharmacies. Due to this, patients with poor financial condition are in trouble.

Insureds say that even though they have health insurance, they have to take loans for medicines and sell their houses. 

Demanding easy availability of medicine, they complained that despite reaching the Ministry of Health, Health Insurance Board and other agencies, they were not heard. 

Health Minister Pradip Paudel, on the occasion of reaching 100 days after assuming office, claimed last October that 60 percent of medicines were available in big hospitals in the past, but now 90 percent are available. But even now, Sangeeta Thapa of Dolakha Tamakoshi Rural Municipality-5, who is suffering from kidney disease, is not getting the medicine she needs to take regularly from the government pharmacy and is buying it from the private sector.

Her husband Ashta Bahadur Choulagain, who was found at Veer Hospital on Wednesday, said, "When the kidneys are damaged, the patient's body is lacking blood." Veer's doctor has prescribed 800 mg of Foscheck brand medicine to help increase blood flow. This drug was never found in Veer's pharmacy.'

According to him, the drug costs 350 rupees per leaf. Chaulagai said that despite having health insurance, 3,500 rupees are being spent on a single medicine.

Savina Timilsena, another kidney sufferer from Dolakha, has also taken health insurance. But Ipofit 6000, which is given by injection to increase blood in the body, has been purchasing from private pharmacies. According to his uncle Ved Prasad Timilsena, the medicine should be used up to 10 times a year. "It costs 1,400 rupees to pay once," he said. 

According to the data of the Department of Health Services, there are more than 6 thousand patients undergoing dialysis in Nepal. Patients with cancer, heart, pediatric and other chronic diseases also did not get medicine easily. There are more than 29 thousand chronic patients in the country. 

Sahid Dharmabhakta National Human Organ Transplantation Center Bhaktapur, Tervi Teaching Hospital, Kanti Children's Hospital, National Trauma Center and other major hospitals of the country are not able to get medicines easily. According to an official of the Health Insurance Board, not inviting tenders in time to purchase medicines, doctors prescribing medicines to patients  During

ing, drugs are not received in the hospital due to reasons such as writing the company name instead of the generic name, having to sell at the price determined by the insurance board, causing losses to the hospital, and also having a commission game. In paragraph-6 of the Health Insurance Regulations, 075, there is a provision that the service provider must arrange a pharmacy to provide medicine 24 hours a day and must conform to the standards set by the government. 

If the service is not provided in accordance with the contract, records are not updated or false reports are submitted, if the program is negligent or if the service is available in your organization, the contract can be suspended or canceled. 

former expert member of health insurance board. Suresh Tiwari said that the Ministry of Health, the Health Insurance Board, and the Drug Administration Department are all responsible for the insured not getting the service. "These three agencies should monitor and take action against the culprits," he said, "otherwise the law should be tightened." 

Ministry of Health spokesperson Dr. Prakash Budhathoki said that the inability to provide medicines listed by the Health Insurance Board is a weakness of the hospital management. "Due to the pressure of the ministry's daily work and the number of hospitals, it is not possible to continue monitoring," he said. If there is a complaint, we will follow up.' 

According to the data of the Health Insurance Board, from July to December 26, more than 15,000 insured people have complained that they have not received services as per the contract. In the financial year 2079/80, there are 146 written complaints received from Hello Government, National Vigilance Center, Commission for Investigation of Abuse of Authority, according to the board's data. But the relevant agencies are not interested in monitoring and regulation. Due to the problem of getting services, the number of new insured has not increased significantly, the renewal of insured is decreasing.

The number of insured persons in the total population of the country is only 16 percent i.e. 46 lakh 66 thousand. The number of renewals of insured was 75 percent in 2077/78, 64 percent in 2078/79 and 59 percent in 2079/80. The board has not released the data for 2080/81. 

Vikesh Malla, the information officer of the Health Insurance Board informed that a quick complaint management committee has been formed and said that they will take the initiative to solve the problem through the committee. 

"If the service is not provided according to the agreement between the board and the hospital, the agreement may be cancelled," he said. Veer Hospital Information Officer Sitaram Khadka said that if there is a shortage of medicines that were missed during the first tender, another tender will be made soon. 

Harihari Pokharel, the spokesperson of Shahid Dharmabhakta National Human Organ Transplantation Center, said that there is also a problem because patients look for drugs according to the company's name. "When prescribing medicine to the doctor, I have been requesting to write the generic name instead of the company name," he said.

Both the post of Chairman and Executive Director are vacant in the Health Insurance Board. The then chairman of the board, Dr. Gunraj Lohani, resigned last August. The four-year term of the executive director of the board was completed on December 25. 

The insurance program started by the government from Kailali on 25 Chait 2072 has now been implemented in 77 districts. 440 health institutions have contracted to provide services under the insurance program. There is a provision to provide health facilities up to one lakh rupees per family (up to 5 people) per year, and if the amount is increased at the rate of 700 rupees per person, services equal to 20,000 rupees will be added. The maximum service facility limit is up to Rs 2 lakh (family members of 10 members). There is a rule that a 10 percent fee must be paid for the service.