PESHAWAR: After receiving Rs5 billion from the Khyber Pakhtunkhwa government last Monday for the resumption of its health insurance scheme, the State Life Insurance Corporation has sought Rs400 million additional funds to set up a “reserve fund” to ensure uninterrupted cancer treatment as well as dialysis for patients covered by the Sehat Card Plus, say officials.

They told Dawn that the SCP resumed in the province’s hospitals in both the public and private sectors on March 12 after remaining partially suspended for more than one year.

The officials said 9,000 patients were admitted to hospitals in the province in the last week for free treatment under the government’s health insurance programme.

They added that Rs177.1 million was spent on the patients admitted.

Asks government to provide Rs400m for initiative

The officials said they had informed health minister Syed Qasim Ali Shah that the SCP required to establish a reserve fund to make sure that cancer patients and those with damaged kidneys could avail themselves of complete care under the health insurance scheme.

They said cancer and kidney failure required long treatment and extra money.

The officials said normally, patients got free treatment when its cost stayed within the limit of Rs400,000, but if the cost went beyond that, the remaining amount was paid from the reserve fund, but that currently didn’t exist.

They said under the SCP, every family permanently living in Khyber Pakhtunkhwa could avail itself of health services up to Rs1 million annually, but if Rs400,000 was spent, the matter was sent to a committee to sanction the rest of the amount from the reserve fund.

The officials said the Sehat Card programme was launched in 2015, covering a few people in four selected districts, but was later expanded to the entire population of Khyber Pakhtunkhwa.

They said under the programme, Rs70.342 billion had been spent on the treatment of 2.812 million people, and the treatment included 164 kidney and 64 liver transplants, 169,107 cardiac procedures, 530,041 dialysis sessions, and 54,710 chemotherapy cases.

The officials said liver transplants cost Rs5 million and renal transplants Rs1.4 million and no plans were in the works to resume them.

They added that the SLIC, the executor of the programme, had received Rs5 billion from the government but Rs17 billion dues had yet to be cleared.

“The insurer will decide about transplants when it gets more government funding. We are waiting for these procedures to resume,” an official told Dawn.

He, however, said dialysis and cancer treatments were very important and the patients couldn’t be left halfway through treatment.

“Most of these patients consume their permissible limit in four to six months and have to suffer for the rest of the year,” he said.

The official said the health minister was briefed about the situation and was hopeful about the early release of funds.

He said the patients needing cancer treatment and dialysis were generally very poor, and while the cost of treatment was very high, the government wanted to ensure their free care without interruption.

Other officials said the programme suffered during the last caretaker government in the province as it didn’t allocate money to keep it afloat.

They said the SLIC used to suspend and resume the programme during the caretaker government due to a lack of funds, while free services were restricted to cancer, dialysis, and emergencies in Oct 2023.

The officials said the people requiring cardiac care had also been awaiting the provision of free health services since the re-launch of the SCP last week.

They, however, said the people needing liver and renal transplants were likely to get much benefit from the programme as both procedures consumed Rs5 million and Rs1.4 million, respectively.

The officials said the suspension of SCP had adversely impacted more than 20 people, who had already undergone many investigations prior to renal transplants at hospitals, but there were no prospects that their free procedures would take place anytime soon.

They said the PTI, which pioneered the programme, was required to ensure the provision of funds for transplants.

The officials, however, said patients requiring transplants had to wait as the State Life Insurance Corporation was expecting more funds to come in from the government to resume transplants.

They said the insurer had received Rs5 billion from the government and would get Rs3 billion more on a monthly basis to run the programme across the province.

Published in Dawn, March 19th, 2024