SL Medical Association opposes insurance scheme for children

The Sri Lanka Medical Association ( SLMA) has urged the Government to reconsider a proposal to introduce a health insurance scheme for all school children on the grounds that it lacks consultations with key stakeholders and impacts on the current free health service.

Earlier this week, the Cabinet approved a proposal to introduce an insurance scheme for all school children between the ages of 5 and 19 years at a cost of Rs. 2700 million to the government. The Ministry of Education has already taken steps to commence implementation of the insurance scheme, which the SLMA said it was deeply concerned about.

The SLMA in a media release said there were no consultations with relevant stakeholders pertaining to this scheme. “Neither the Ministry of Health nor professional medical bodies has been engaged in planning or implementing the insurance scheme, which will have wide- ranging implications for the health sector,” it said.

Furthermore, while there already is a free national health service, the justification for a new insurance scheme for school- going children is unclear. “If the insurance scheme is implemented, the government will cover premiums for an age group that generally requires very little curative care. If at all, this health insurance scheme should target children with critical and chronic illnesses who are unable to access timely care in the public health sector,” the association said, pointing out that these concerns were also earlier raised in the SLMA’s budget proposals for 2018.

The major health issues afflicting the school-going population such as malnutrition, obesity, unhealthy eating patterns, insufficient physical activity, exam stress and broader mental health concerns will not be addressed by this insurance scheme. The solutions to these problems lie in health promotion rather than the provision of curative care, it added.

“If the said health insurance scheme is to advance equity of access, there needs to be a strong regulatory framework in place. We see no evidence of plans to implement mechanisms to regulate the private healthcare and insurance industries,” the association noted.

The SLMA said the Government should direct funds – set aside for the proposed new scheme - toward strengthening primary care. “Developing a strong primary care system, encompassing preventive and curative services, will be beneficial to all Sri Lankans, including school-going children,” it said.