Taimur Jhagra are paid for by the government, so that the person with low income can afford access to the same health insurance that people with well-paying middle class jobs have access to. What both have in common is a coverage limit: the total amount of money per year that the insurance plan will pay to cover expenses. The Sehat Insaf program will cover up Rs600,000 per year per family (Rs300,000 cost hospital procedures, and up to Rs120,000 per family per year for other types of hospital-based healthcare coverage. the most expensive hospitals or the most expensive diseases, but they are a lot more money than what most low-income people currently have access to. And instead of begging their employers for help, they now have access to a government program that gives them similar access to healthcare services. With this card, the labourer working on building a skyscraper has access to the same hospitals and a similar level of services as the mid-level banker walking into that building to work. While this program has not yet spread nationwide, it already covers an estimated 7 million families, according to the federal health ministry, or about 21% of all households in Pakistan. The program, as you may have noticed, is not modeled after the kind of healthcare coverage programs found in Europe or Canada. Instead, it is closer in design to the Managed Medicaid program in the United States, where assistance of the US federal government – pay the premiums on health insurance plans for low income individuals and families. In Pakistan, the structure is almost identical: the provincial governments generally run - tance from the federal government, which also sets basic standards for the program and what it is supposed to cover. The actual insurance is administered by private sector – and government-owned – insurance companies, with the government paying the premiums. staff underpaid and overworked – resulting in a poor quality of care offered. - ing on healthcare accounted for about 35.7% of total spending on healthcare in Pakistan in spending, most Pakistani know that they are on their own, with not much assistance coming from the government. spending on healthcare does go to the poor (mostly because anyone who can afford private sector healthcare prefers that over the public low-income families can afford, and what middle class and upper income people can afford is tremendous. By providing health insurance to the bottom 21% of families (a number that may rise achieving two policy goals: improving access to quality private sector care to those who are currently locked out of it by price, while at the same time reducing overcrowding (and public sector healthcare facilities. What does this mean for the healthcare sector? Well, if you are the owner or operator of any type of healthcare facility – hospitals, Why expanding insurance coverage matters W hy is this relevant? Because in Pakistan, the vast majority of healthcare costs are paid for out-of-pocket by private individuals. Yes, the government maintains public sector hospitals that provide free or very low cost healthcare to anyone, but those facilities tend to be overcrowded – and their COVER STORY
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