KATHMANDU, March 19: The Ministry of Health and Population (MoHP) made public the Health Insurance Recommendation Task Force's report on Sunday. The report, which was submitted in January, was released by the ministry after two months. The task force has provided 15 recommendations to make health insurance more effective.
The report suggests increasing the coverage of health insurance from the current one lakh to five lakhs, integrating health programs scattered across all three tiers of government into the insurance system to eliminate duplication, and making health insurance mandatory for public service employees. It also recommends ensuring universal access to health insurance.
Additionally, the task force has advised incorporating all social security programs under health insurance and initiating policy reforms to secure funding sources. Other suggestions include implementing a co-payment policy, bringing healthcare-related grant programs under the Health Insurance Act, granting full autonomy to the Health Insurance Board, and conducting a study on the strengths and risks of the insurance system for better management.
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During the report's unveiling, Minister for Health and Population Pradeep Paudel said that the government is working on streamlining health insurance without burdening the general public. “We have made preparations, and now every level of government will have a unit providing health insurance,” he said. He emphasized that health insurance is not solely a federal government responsibility but also involves provincial and local governments. “Since health insurance falls under all three levels of government, efforts should be made to strengthen and utilize its fund effectively,” he added.
According to Minister Paudel, the Health Insurance Fund currently holds around three billion rupees. He suggested that adopting a single-window system for expenditures could help address the financial challenges in the insurance system. The ministry aims to increase the fund to ten billion rupees in the next fiscal year to ensure sustainability.
Minister Paudel also highlighted that reducing the consumption of sugar-based products, as well as allocating a small portion of taxes collected from pollutants, tobacco, and alcohol to the health insurance fund, could help strengthen the system. This approach, he said, would also ease the financial burden of insurance on citizens.
The task force, led by Dr Shambhu Acharya, submitted the report to Minister Paudel on December 31. The committee included senior cardiologist Dr Bhagwan Koirala, development economists, current Executive Director of the Health Insurance Board Dr. Raghuraj Kafle, and officials from the ministries of health and finance.
On Sunday, the ministry also unveiled a health insurance action plan. This plan includes provisions to cover state-paid employees under the health insurance fund, with the government contributing one percent of employees’ salaries to the fund. Based on the report, the ministry had earlier presented the action plan to Prime Minister KP Sharma Oli. The implementation phase of both the recommendations and the action plan has already begun, according to ministry spokesperson Dr. Prakash Budhathoki.
