ISLAMABAD, Aug 15: Experts at a seminar here on Monday urged the government to explore alternative mechanisms for generating resources to improve the existing health care system that was in a shambles due to an inefficient public sector and unregulated private sector.

The seminar on “Raising Revenue for Pakistan Health Care; Options and Problems” was organised by the Sustainable Development Policy Institute (SDPI).

The experts were of the opinion that at present Pakistan’s health care scenario presented a bleak picture dominated by an inefficient public sector and unregulated private sector. They discussed the pros and cons of various modes of health financing, including tax-based financing, user fees, community financing and health insurance and the possibility of their proper implementation in Pakistan.

They said Pakistan’s health sector faced the problems of scarce resources, burden of increasing number of diseases and disease-stricken people, unregulated private sector, weak tax base and administration and lack of alternative mechanisms.

The seminar was told that Pakistan spent less than one per cent of its Gross National Product (GNP) and less than four per cent of its Gross Domestic Product (GDP) as total expenditure on health and health care. For a population exceeding 148 million, the per capita health expenditure in Pakistan was $16, which was one of the lowest in the region.

Dr Shafqat Shehzad of SDPI said a proper understanding was needed about pro-poor health care financing policies before developing them. She said financing of health sector in Pakistan was not defined and well-planned.

She said though various financing instruments could be tested to raise revenue, it was important to determine the socio- economic and geographical profiling of people, who needed health care most for gauging utilisation level, as under-utilisation was a major problem for Pakistan’s health sector.

She said Pakistan’s health care costs were consistently rising and being a developing country and having a large rural population and informal sector, the government’s taxation capacity was low.

Dr Shafqat said the government should adopt appropriate financial strategies, taking care of adjustment for inflation, and minimize the risks for adverse selection and moral hazards. She said schemes for health insurance could be introduced on private and social basis to extend coverage.

Dr Talib Lashari from The Network for Consumer Protection called for a new health care financing, which, according to him, should be a combination of tax revenue, community financing and social and private insurance.