KATHMANDU, August 2: Although almost seven years have passed since the operation of the health insurance program, this program has not started yet in all local bodies in the Kathmandu Valley.
According to the Health Insurance Board, health insurance has not been started yet in Kathmandu Metropolis, Budhanilkantha Municipality, Nagarjuna Municipality and Lalitpur Metropolis.
Shambhu Prasad Gyawali, the spokesperson for the Health Insurance Board, said that the insurance program has not been implemented in the Valley as the local governments remain passive on this issue. He says that even though the board is repeatedly trying to coordinate to operate the insurance program, the local governments have not shown their interest in it.
The local governments have to select registered partners to operate the health insurance program. Gyawali said that the program could not be started because these four local governments have not selected their registered partners. He complained that despite the Health Insurance Board requesting for coordination with Budhanilkantha Municipality, the municipality ignored the request.
In other three municipalities, the program could not be started due to lack of first service points. A government health institution is required for the first service point. The health insurance program has not been implemented due to the failure to decide the place of first service point. Gyawali informed Republica that since some municipalities are determining the first service points, the program will be started soon in those municipalities as well.
Nabin Manandhar, the spokesperson for Kathmandu Metropolis, says that since the metropolis does not have its own health institution, the insurance program cannot be conducted. He says, “A health institution with its own doctor is needed to operate the health insurance program. But there is only a clinic in Kathmandu. Now we are establishing a health institution. Now we will operate a health insurance program soon.”
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He said that the program will be conducted by opening health institutions in all 32 wards of the metropolis. He says that two health institutions have already been operated and four of them are in the process of being opened.
Similarly, Raju Maharjan, the spokesperson for Lalitpur Metropolitan City (LMC), says that due to the delay in coordination by the Health Insurance Board, the implementation of the health insurance program has also been delayed. He says that the LMC needs its own health institution to operate the insurance program, so the LMC is going to establish its own health institutions.
The health insurance program is a program under social security. A family with five members can get health insurance at Rs 3,500 per year, a family with six to seven members at Rs 4,700 per year and a family with 10 members at Rs 7,000 per year.
Family members who have health insurance will get free medical services worth Rs 100,000 per year. This facility of health insurance can be taken from 466 private and government health institutions across the country.
On April 7, 2016, the health insurance program was started for the first time from Kailali District. After that, this program was implemented across the country.
In the seven years since the health insurance program started, about 6,820,000 people have been insured with health insurance. According to the Health Insurance Board, this data is recorded till mid-July of the previous fiscal year.
Most of the insured are from Koshi Province and the least from Madhesh Province. Bagmati Province holds second position after Koshi Province. Then there are Lumbini Province, Gandaki Province, Sudurpaschim Province and Karnali Province, respectively.
Spokesman Gyawali says that the number of insured persons is very low in Madhesh Province because there are few organizations that provide health services in Madhesh Province.
The Health Insurance Board has collected Rs 2 billion from the insured till mid-July. Similarly, Rs 13.5 billion has been paid. By mid-July, 64 percent of those who had done health insurance had renewed their membership.
The Health Insurance Board received Rs 7.5 billion in grants from the government in the fiscal year 2079/80 BS.
