Read on Twitter
1. Before I rebut this article, I would just say that it wouldn't have hurt you to add that the article is written by opposition member who would have a bone to pick with the government in your tweet so that people would have full picture. https://twitter.com/titojourno/status/1357910956320436224
2. So there's a lot of unpack here. Firstly, the article doesn't quote a single piece of evidence for claims of fraud, misuse, ghost treatments and unsustainability. It is all just conjecture and hearsay which we hear everyday from skeptics. Internal audits have cleared but now
3. Govt is moving towards third party audit to lay all these unfounded speculations and conjectures to rest. As of now there's no substantiated proof of leakages, ghost treatments or corruption at all. Yes there could be minor irregularities which any program of this size has but
4. that is the extent of it. The author claims that the financial model is unsustainable and should be piloted. Unfortunate that the member doesn't know that it has been piloted for 6 years in three phases with KfW and other partners after which it was decided to be expanded.
5. How much more piloting do you need? The funding is coming from the government because it has it. Yes the risk is always there of fund shortage but it is true for every government program. There's reasonable expectation of revenue increase in the coming years. KPRA exceptional
6. growth in revenue collection is just one example. The government is comfortable funding the program which is why it went into contract with SLIC. The health budget is more than 110 billion and sparing 15% of it for UHIC is a sensible and worthy endeavor.
7. The writer claims that government will pay 18 billion and treatments will be much higher than that. That is simply untrue. As of now in all the three phases, claims have not exceeded the premium amount and actually there has been a big gap. The claims after
8. universal coverage are also not expected to exceed 18bn. Early data suggests they will fall within the range of 8-12bn. Also the writer doesn't know that SLIC will reimburse almost all of the difference between 18bn and yearly claims back to government. Similarly
9. a large part of the claims that come from public sector would eventually flow back to the government so that will be savings for the governments. The worst case scenario will take claims above 18bn in which case premiums can go up and government can reevaluate the scheme.
10. The writer claims that health coverage is multi-dimsensional and covers all aspects. That is true but he clearly misses the point that it is tertiary and secondary care which is uncovered for most public in public hospitals. Primary care is available at free of cost
11. for the general public in public hospitals. Preventive care and immunization programs are also free of cost for general public. The only thing that was missing has now been covered. Yes, the state of our public health infrastructure and facilities is in bad shape, all thanks
12. the governance failures of the member's party and their allies now. PTI government has taken the task of fixing health facilities across the province instead of making new ones to buy votes. A whole primary and secondary care revamp is going on simultaneously to ensure
13. that our healthcare becomes multi-dimensional which the member's party never tried to do. The member then claims that it will close public sector shop because private sector will get all the patients. Why does it hurt if a poor person now has access to better health
14. facilities in private sector because we paid no attention to public sector. However, his assertion is not true. The public sector hospitals like MTIs and DHQs are getting significant footfall and with increased competition they will be forced to upgrade their service delivery
15. to get more patients. We are designing the packages in a way that hospitals get to keep some part of the cost so they are incentivized to attract more patients and reap benefits. There is also ample evidence that cost per patient is much higher in public hospitals compared to
16. private sector hospitals because of government inefficiencies and leakages. If in case more people are going to private sector, it eventually reduces the cost per patient for government which reduces the overall health budget for the government along with added benefit
17. of improved service delivery. Private sector will always play the bigger part in this scheme because if public sector was so competitive and efficient we wouldn't need this scheme altogether. The government has to ensure that there are no price spirals and quality is
18. regulated. The writer seems to be unaware that here is detailed and through process through which hospitals are empaneled. Also not just hospitals go through rigorous checking, but it's not guaranteed that the whole hospital will be empaneled. Some services can be denied
19. empanelment because of low quality. Other than that depending on the quality, hospitals are categorized in different categories and higher the categorization, higher the package hospital is offered. There's an incentive for the hospitals to improve quality so they can
20. earn higher amounts for same procedures. Also the cost of each procedure for each category is capped to ensure that hospitals don't charge whatever they want. Many hospitals have opted out because they are unable to offer services at that package. This ensures that there
21. is no price spiral and the onus is on hospitals to improve quality because in universal coverage when everyone's paying through the card, the cost of losing patients could be as high as the closure of your business. There is high competition developing to attract patients.
22. As far as regulation is concerned, it's a valid concern again all thanks to the mis-governance of the past that allowed hospitals to work unregulated. Again the government has now realized that the success of this scheme depends on strong regulation which is why it has moved
23. swiftly to get new boards for Healthcare Commission and Foundation so they can provide strict regulatory oversight. Yes it will take time but it's part of a multi-pronged strategy to address plethora of deficiencies left because of poor governance of the past decades.
24. It is very unfortunate that the member decided to launch a partisan attack against a vital scheme without knowing facts or basic ground realities and only relying on fake news, conjecture and rumors. It would do the member well to educate himself on the basics and then
25. contribute towards an informed discourse because obviously this scheme is not perfect and there will be regular reviews and tweaks to ensure that valid feedback is incorporated so the scheme becomes better with time. There's a lot more to address but later on that. End.
