The Punjab government has undertaken significant initiatives to ensure thelong-term financial sustainability of the Sehat Sahulat ProgrammePhase-III, also known as Universal Health Insurance in Punjab. Respondingto directives from the Punjab Health Initiative Management Company (PHIMC)and the State Life Insurance Corporation (SLIC), the government haspromptly implemented substantial changes. Among these changes, thegovernment has immediately halted cataract surgeries under the SehatSahulat Programme within Punjab. Simultaneously, they have enforced arequirement of a 30 percent co-payment for various essential medical andsurgical procedures performed in private empanelled hospitals.
Effective from September 1, 2023, these decisions have been made in lightof the rising tide of complaints related to the use of substandard lensesduring cataract surgeries and allegations of malpractice in other medicalprocedures conducted in private hospitals. Dr. Ali Razzaque, CEO of PHIMC,has articulated that the primary objective of these measures is todiscourage the inappropriate transfer of patients from public healthcarefacilities to private ones for relatively uncomplicated procedures.
The 30 percent claims co-payment, in addition to impacting cataractsurgeries, will also extend its reach to laparoscopic surgeries,cholecystectomy, hernioplasty, hysterectomy, appendicectomy, tonsillectomy,and trans-urethral resection of prostate (TURP) procedures conducted inprivate empanelled hospitals as part of the Sehat Programme.
In response to the alarming reports of subpar lenses used in cataractprocedures, the government has taken further steps to address this issue.They have established a committee led by Prof. Dr. Asad Aslam Khan fromKing Edward Medical University (KEMU), Lahore. This committee’s primarymission is to investigate and evaluate the practices of private sectorhealth facilities, assess the availability of quality lenses, investigatecomplaints related to the use of unapproved lenses, and explore thefeasibility of incorporating approved lenses within the existing packagerates.
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These measures are integral to safeguarding the integrity of the SehatSahulat Programme Phase-III and ensuring that beneficiaries receive thehighest standard of healthcare services while promoting financialresponsibility within the program