Health insurance program yet to start in three local units in Kathmandu despite its nationwide implementation

Health insurance program yet to start in three local units in Kathmandu despite its nationwide implementation
By Republica
Published: December 19, 2023 07:00 PM

KATHMANDU, Dec 19: The nationwide health insurance program launched by the government is yet to start in three local units of Kathmandu District. The Kathmandu Metropolis, Budhanilkantha Municipality and the Nagarjun Municipality have not yet implemented the program.

In the nearby Lalitpur metropolis, Prime Minister Pushpa Kamal Dahal inaugurated the program on Monday.

Introduced in 2072 BS, the program aims to provide accessible healthcare services to all citizens.

Health Insurance Board's Information Officer Om Kumari Kandel said the failure to fix the first service points in three local units has caused problems in implementing the program. Major central hospitals in the Kathmandu Valley see a high influx of referral cases, making it impractical for them to serve as the first service points in terms of getting medical care under the insurance scheme. The respective governments are expected to fix the matter and once they determine the locations, the program will be implemented. 

The Bir Hospital, Tribhuvan University Teaching Hospital, Patan Academy of Health Sciences, Sukraraj Tropical Hospital and Civil Service Hospital are already overwhelmed by referral cases from other first service points and they are unwilling to act as the first service points for three local levels.

Kathmandu metropolis health department Chief Ram Prasad Paudel said they are in touch with the Board to find a concrete progress for the program implementation. As he said, ward office-based Urban Health Promotion Center will serve as the first service points in case of the Metropolis.

An agreement to this regard with the Board is likely within a week.

Though 7.4 million have been connected with the Board, only 4.7 million remain active.

Presently, the Board facilitates the implementation of the health insurance program in 77 districts, providing free treatment services to an insured family up to 100,000. The yearly insurance premium per family is Rs 3,500.  For families with more than five members, an additional amount of Rs 700 is chargeable per head.

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