The Punjab Government’s Initiative to Ensure Financial Viability of Sehat Sahulat Programme Phase-III/Universal Health Insurance in Punjab
In response to directives from the Punjab Health Initiative Management Company (PHIMC) and the State Life Insurance Corporation (SLIC), the Punjab government has implemented significant measures to uphold the financial sustainability of the Sehat Sahulat Programme in the region.
Effective from September 1, 2023, the government has taken the following actions:
- Suspension of Cataract Surgeries: Cataract surgeries under the Sehat Sahulat Programme in Punjab have been immediately suspended due to numerous complaints regarding the use of substandard lenses during these procedures and reports of malpractices in other medical interventions at private empanelled hospitals.
- 30% Payment Requirement: A 30 percent co-payment requirement has been imposed for various critical medical and surgical interventions conducted at private empanelled hospitals under the Sehat Sahulat Programme.
PHIMC CEO, Dr. Ali Razzaque, emphasized that these measures aim to discourage the inappropriate transfer of patients from public hospitals to private facilities for simple procedures.
The 30 percent claims co-payment will be applicable to the following procedures conducted at private empanelled hospitals under the Sehat Programme: laparoscopic surgeries, cholecystectomy, hernioplasty, hysterectomy, appendicectomy, tonsillectomy, and trans-urethral resection of prostate (TURP).
To investigate the reported usage of low-quality lenses in cataract surgeries, the government has established a committee led by Prof. Dr. Asad Aslam Khan from King Edward Medical University (KEMU), Lahore. This committee’s mandate is to assess the practices of private sector health facilities, the availability of lenses, complaints related to unapproved lens use, and the feasibility of incorporating approved lenses within existing package rates.
The Punjab government remains steadfast in its commitment to delivering high-quality healthcare through the Sehat Sahulat Programme while concurrently ensuring transparency and efficiency within the healthcare system.