Health insurance in pakistan
Punjab Health Coverage Code (PHCC) was developed by the government and introduced into law in 2004, as a comprehensive system of healthcare provision for Pakistani population. It covers all aspects of healthcare services including primary care services on a case-by-case basis; emergency intervention; inpatient rehabilitation centers; other hospitals that provide specialized treatments such as orthopedic and cardiac procedures; rehabilitation treatment centers and residential care (Hospitals). The main purpose of PHCC is to ensure universal health coverage for everyone, regardless of age, gender, employment status or social class, and it has been shown that individuals have access to the highest quality healthcare services at no additional cost to them. There are four groups of people who have access to PHCC — those covered under general medical insurance, under the federal public health plan, on self-employed or unemployed, and families with persons without any form of regular income distribution. Under PHCC, it is mandatory for health insurance companies not only to offer an individual the right to access health services, but also to choose the best health facility to take their insurance policy. As a result, healthcare system in Pakistan has adopted a market pricing mechanism. It is expected that this model will remain effective for several years. Therefore, in the absence of health insurance, people would be forced to travel long distances to get basic healthcare services because they would have to pay a heavy price for the service. However, if health insurance is available to consumers, then they could receive a lower price for getting medical services. Thus, after the implementation of PHCCs, many new problems emerged as many people did not have access to healthcare services. These new problems were caused by non-existent healthcare system and financial constraints, etc.
Health insurance in Pakistan can be both private or public-owned. Public sector may include the provincial government, municipalities, and local authorities. Private sector holds 70% of the share. A majority of people in Pakistan rely on Islamic banks to finance healthcare services. Most of these health insurance companies exist in foreign countries, so there are numerous types of healthcare insurance in Pakistan. People mainly use private sector insurance for those who cannot afford insurance products from healthcare institutions. They do not have to pay taxes on insurance premiums because they do not get health benefits for which they have to pay tax on their personal earnings. On contrary, Pakistanis have to pay extra tax in order to acquire healthcare benefits related to some issues like birth control, pregnancy, and others. Moreover, people usually have some kind of insurance policy, especially those whose family members had the same disease. For example, people have life insurance policies to pay death benefit when their sibling dies.
There exist various forms of healthcare insurance to meet diverse needs of people. The following table shows the main healthcare insurance organizations in Pakistan. Currently there are eight organizations that provide healthcare insurance in the country — SAAIBIA, National Institute of Nursing and Midwives, Lahore, MQIB, Lahore, PIMS, TIBHB, SHIPH, GIZBA, SAMA and JNCHC-National Health Authority Health Limited
SAAIBIA: It provides insurance cover to the first-time medical students. Their premium is Rs 0.25 million in every year. This organization offers undergraduate courses, postgraduate degrees and specialised degrees in nursing.
The number of employees working in SIAB is approximately 880. All the staff members are graduates in nursing. At least 30% of staff members are qualified nurses, while 50% of them work in different departments. SIA is considered one of the leading insurance agencies in Pakistan.
National Institute of Nursing and Midwives (NINM): NINM is a national institution established in 1990 in Rawalpindi from where it conducts training programs and research work related to midwifery and its practice. It offers education on topics like human health, women’s health, maternity care, neonatal care, and others.
It holds a total of 24 medical degree seats including five master’s degrees apart from 1 PhD course. Its focus is on providing female nurses with academic and practical experience to enable them to practice as professional professionals. Nearly half of the population has to pay monthly payments based on the minimum daily salary provided by the central government. The average monthly rate is Rs 12,000 per person.
The annual budget of the institute is around Rs 13 billion and the total number of staff members is over 1000. More than 25,000 people have to join each year. Although this organization pays monthly stipends of Rs 7,500 per family member (first-time applicant, post graduate, and senior nurses), patients get their bills only in case of serious illnesses, while maternity, accident, fall, and cancer patients pay separately. Besides, in case of emergency cases and urgent needs, patients can pay the lump sum amount within one month.
The number of employed people in NINM is about 500. Many nursing students prefer this hospital as their preferred hospital because of its attractive packages, free maternity care, and maternity care facilities in Islamabad.
National Teaching Institute for Women’s Engineering and Science (NTIEWES) has given an honorarium by the government to women. Now they have more than 1500 nursing and midwifery lecturers who teach nursing, midwifery, and other subjects. It has 20-plus centres of excellence for all nursing and midwifery. Also, it has a separate department to educate about male nurses and midwives. To enhance teaching proficiency and quality, it also conducts trainings for teachers on modern teaching methods.
The management of NINM was constituted in 1992 and since then, more than 4,000 students have graduated from this institute. The university has 40 courses in nursing and midwifery. Of the course 40 different schools are run by NINM in Rawalpindi, Sialkot, Balochistan, and Dir Upper regions of Punjab and GB Rawalpindi. Some of the famous institutions include Aligarh Muslim University, Maulana Rafiuddin Ullah Medical College, Muhammad Ali Jinnah Educational Trust, Qadian, Bahu Khan Medical School & Hospital, Chitral University, Dera Murad Medical College, HUJI, Rah Baba Tehsil Hospital, Rahimyat Khan Hospital, Kot Lakhpatan District Hospital. And others.
National Institute for Post Graduate Diploma in Nursing Education (NIGDNE) provides training for registered midwives. Their yearly budget is around Rs 9.5 billion (USD 0.2 Billion) and their staff size is about 5,200 plus. Their range of services include nursing, midwifery, allied health, gynecology, internal medicine, general surgery, neonatal/postnatal care, pediatrics, surgery and orthopaedics among others. Their main goal is to impart knowledge and skills to midwives to improve their overall performance.
NIGDNE has a very good reputation in Pakistan because of their wide range of educational activities – from short lectures and conference talks, workshops and seminars-to offering international online courses. With the support of Pakistan Institution of Nursing, they conduct multidisciplinary symposia on men and women health and nutrition. Their major aim is to increase their patient base globally and make sure that they give the best out of their resources to people from across the world. The hospital has 22 full length halls, 5 operating rooms, 2 intensive care units, 2 paediatric unit, 6 labor wards, 4 pediatric clinics, 9 maternity wards of which are multi-disciplinary, 9 obstetrics units and 10 surgical beds; three high dependency units, 3 Intensive Care Units, 1 ICU; four Emergency Department; 11 maternity ward wards, four cots, six ultrasound labs, 25 incubators for babies weighing 5kgs, two laparoscopy suites and seven ICU and operation theatres. One of the biggest challenge faced during the last few years is lack of skilled labour workers. But, this government is trying to overcome this problem by developing capacity for better recruitment of nurses across the province through its Ehsas programme.
Majlis Baht Dar e Khatam Lahzatul Islami (MBKLII) provides health insurance cover to Lahoris in a periodical way for up to Rs 90,000. The employer or his company pays up to 95% of premiums.
The insurance policy is divided into two parts, namely insured part or un insured part. The insurer pays 60%; that is 60 percent, after deducting 20%. So, here the employer will pay only 1/3rd of the price of insurance as the provider will pass on the rest to the customer. If either he becomes ill, he has to pay money to him, and if the insurer refuses to pay the claims they have to pay up to Rs 10,000.
Usually, MBKLII has a big presence in Lahoris and pays its own employees to visit customers. When clients visit doctors they often come back again the next day because they do not want to wait till morning when all the medical staff of the clinic go back home. The reason behind this condition is that the doctors are required to return home after taking the sick patients to the hospital. Then they return back to office after giving all their hard earned money back to the hospital. The office also needs to be cleaned up from time to time. The cleaners must clean up the entire floors and the offices within an hour.
Majlis Baht Qamar e Khawat
Qamar e Khawat is a small organisation started in 2009. Initially known as Qamar e Khawat, initially its name was derived from “Qar-Khawat
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