The outstanding amount has increased to 17.42 billion rupees as the health insurance board run by the government has not been able to make payments for years. This amount is up to February 25. Due to non-payment, the amount claimed by the service provider in the current financial year has not been settled. The service provider organizations that are supposed to be paid by the board after joining have not been paid even one and a half billion rupees for the last financial year because they don't have the money.

According to Vikesh Malla, Information Officer of the Health Insurance Board, the board currently has 3.7 billion rupees in its funds. According to the data of the board, since the establishment of the board in 2072 till 2079/80, 11 billion 62 crore 77 lakh 10 thousand rupees have been collected from Premier. But up to this period, the expenditure has been 40 billion 736 million 23 thousand rupees. The board is operating at a loss every year. 484 health institutions including 48 private ones are affiliated to Bima. 99 lakh 23 thousand are insured all over the country.  About 30 million claims of 25 to 30 thousand insured people are received on the

board every day. "According to this calculation, it seems that the arrears of the board will reach about 22 billion by June of the current financial year," he says, "One of the reasons for not being able to complete the training on time is the lack of manpower." Artha had given 10.5 billion rupees as subsidy in the current financial year, while it seems that the annual headcount from Premier is 2.5 billion rupees.

According to the 2078 census, the population of the country is 291 million 64 thousand 578. In the 9 years since the insurance program started, the number of people insured is only 34 percent. The number of new insureds has not increased significantly in recent years. Renewals are also decreasing every year. Insurance renewal was seen at 75 percent till 2077/78. It dropped to 64 percent in 2078/79. It further decreased to 59 percent in 2079/80. The board has not released the data for 2080/81.

Mall says that if the remaining 1.5 billion rupees are paid on the payment day of last year, only 2.20 billion rupees will be left in the fund. "In this regard, if the board cannot increase the number of insured significantly, it is seen that it will be difficult to pay the service providers for the current financial year," he says.

former chairman of the board Dr. Senendraraj Upreti says that behind the failure of the insurance program, there are reasons such as political interference in the board, service provider organizations not providing full service despite having an agreement with the board to operate the insurance program. "Irregularities in the board, lax monitoring and non-implementation of laws and regulations related to insurance are also responsible for the decline of insurance," he says, "If the insurance law provides for mandatory insurance for the families of foreign workers and government employees, there will be no financial problems in the operation of insurance." 

According to him, the practice of claiming payment by submitting false details should also be stopped. "Hospitals that submitted false reports and claimed overpayments had to be brought under the ambit of action," he says.

Ministry of Health spokesperson Dr. Prakash Budhathoki says that preparations are being made to amend the Insurance Act and Regulations so as to integrate the social security program in order to reform the insurance program.

'If a part of the tax levied on products and goods that are directly harmful to health such as plastic, chemical, sugar, and tobacco products can be brought to the insurance, 30-40 billion rupees will be accumulated in the board's fund annually,' he says, 'The issue of payment claims being three times higher in private hospitals than in government hospitals is also questionable. According to the Ministry of Health, if the insured person renews, they will add 75 thousand rupees to the benefit bag of 1 lakh rupees that was not spent that year, bringing the second year's benefit bag to 1 lakh 75 thousand rupees. Dr. Saroj Sharma, Acting Executive Director of the Health Insurance Board, says, "Until now, we need more than 17 billion for payment. We have written to the Prime Minister's Office for their opinion on the lack of budget. There is also a problem when the Ministry of Finance does not send additional funds for the target groups." There are senior citizens who have reached the age of one year. There is a provision that the local, state and central governments will bear 100 percent of the premium for them and 50 percent of the premium amount of the families involved with women volunteers. According to the board, there are 18 lakh 74 thousand 765 families in the target category. The number of insured families is 27 lakh 85 thousand 788.