Social health protection programs conducted by the state are scattered and are being run in different ways, costing the state a huge amount of money. One person gets double-triple facilities while some do not even get basic treatment. Thus, both the health of citizens and the economic health of the country have been adversely affected.
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When someone gets sick in a well-functioning family, even a serious illness, then the rhythm of the family breaks down. The short-term-long-term harassment suffered by the patients and their relatives is significant, they also have to bear the economic-social ups and downs.
The data of the World Bank report shows that 574 thousand 294 citizens are pushed below the poverty line in Nepal every year because of the personal expenses for medical treatment. Since
, the social health security programs conducted by the state have been scattered and are being run in different ways, so the state is spending a lot of money. Out of the estimated 41 billion rupees that will be spent in this way, about 21 billion rupees are spent twice. One person gets double-triple facilities while some do not even get basic treatment. In this way, both the health of citizens and the economic health of the country have been adversely affected.
The welfare state has been providing facilities to citizens through various programs. In Nepal, there are many programs in operation with the aim of providing partial facilities to the citizens. Under the Ministry of Health, there are various programs according to the Social Health Security Plan.
Programs like drug treatment for poor citizens, mother protection, free heart treatment for children below 15 years and senior citizens above 70 years, free treatment for serious diseases for poor citizens are in operation. Health assistance is also provided from the local level. On the recommendation of the ward, free services are also provided through the social service unit of the hospital.
The state government has given health subsidies. Similarly, drug treatment is provided through the Social Security Fund operated under the Ministry of Labour, Employment and Social Security. Through the Ministry of Defense's Military Welfare Fund, the Nepali Army and their families are given free treatment through the Ministry of Home Affairs' Police Welfare Fund.
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 retirees and their families. Similarly, the Employee Provident Fund under the Ministry of Finance, Citizen Investment Fund, various banks have coordinated with the insurance company and given a certain amount to the account holder for treatment.
The less people get the more facilities, the more people are deprived of such facilities. When limited people take double-triple payments, the rest will not get basic facilities. When a single person with access receives benefits from many sources, those without access who really need help may not get natural benefits. At this time, even social justice is fragmented. Therefore, the way of taking double benefits by the same person should be closed. It could finally end the double spending of the state on health care.
Experts say that if the program of social health protection can be conducted through a one-door system, it will be the basis for the end of double spending of the state. Health Minister Pradeep Paudel had also announced the integration of social health protection programs in July 2081. However, there are still social health security programs run under other ministries, even the health programs run under the Ministry of Health have not been able to run through the one-door system.
The coordination role of the Ministry of Health is necessary to include the programs running under different Acts and 'Schemes' in a unified standard. In the report of the Health Insurance Reform Recommendation Task Force, there is a recommendation regarding which section of the law related to the social security program should be amended by which agency. The ministry can take it into context and take initiative.
First of all, a credible initiative is needed to run the social security program under the Ministry of Health through the Insurance Board. Health Minister Paudel's main focus needs to be focused on his own ministry first. The question is also linked to the competence of the insurance board. It is becoming difficult to operate the government health insurance effectively.
The board is unable to analyze payment claims and make payments. It is said that the amount to be paid by the end of the current financial year will reach 24 billion. However, the board has only one billion rupees in its fund. Therefore, integrating more programs based on the current operational structure, manpower and technology is likely to cause more disruption.
That's why the ministry should make the first effort to remove the lack of trust in the citizens. But the way to end the double spending of the state on health care is to run the scattered programs in a one-door system, so the efforts in this direction should be continued.
