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