Nepal, a developing country in South Asia, faces numerous challenges in providing affordable and accessible healthcare to its citizens. Section 30 of the Public Health Act plays a significant role in promoting public health and preventing the spread of diseases. It empowers health authorities to take necessary actions to protect the community's wellbeing, such as enforcing quarantine measures, conducting health inspections, and implementing disease control strategies.
Universal health access is a fundamental human right, and achieving it is crucial for realising sustainable development. By ensuring that everyone has access to quality healthcare services without facing financial hardship, we can significantly reduce health inequalities and improve overall wellbeing. The universal health access help governments and policymakers make informed decisions, allocate resources effectively, and design targeted interventions to address the specific needs of their populations. The Sustainable Development Goals (SDGs), particularly Goal 3, aims to ensure healthy lives and promotes wellbeing for all at all ages. However, there is still inadequacy in current state of healthcare systems, gaps in access to healthcare services, and we need collaborative approach to designing strategies to bridge those gaps.
Against this backdrop, one of the concerning issues is the medical expense payment for Nepali politicians seeking treatment in foreign countries. This practice raises questions about the fairness and equity of healthcare distribution, particularly when compared to the out-of-pocket expenditure of ordinary Nepalis. Let us explore the implications of such medical expense payments to politicians and the out-of-pocket expenditure of Nepali citizens.
Nepali politicians, as public servants, have a responsibility to prioritise the welfare of their citizens. However, the practice of seeking medical treatment abroad, often at the expense of the state, raises concerns about the fairness of healthcare access. While it is understandable that certain medical conditions may require specialised treatment not available locally, the preferential treatment given to politicians creates a disparity in healthcare access. This privilege further exacerbates the existing inequalities in Nepal’s healthcare system.
The out-of-pocket expenditure of Nepali citizens for healthcare is significantly high, with a large portion of the population struggling to afford even basic medical services. According to the World Bank, out-of-pocket expenditure accounted for approximately 55 per cent of total health expenditure in Nepal in 2017. This burden falls disproportionately on the poor and vulnerable sections of society, pushing them further into poverty. The contrast between the financial burden faced by ordinary citizens and the state-funded medical expenses for politicians abroad highlights the lack of equity in the healthcare provision.
The tendency of politicians having medical treatment abroad has several implications for the Nepali healthcare system. Firstly, it diverts resources that could be used to improve local healthcare infrastructure and services. The funds allocated for politicians' medical expenses could be better utilised to enhance healthcare facilities, train medical professionals, and provide essential medicines to the general population.
Secondly, this practice erodes public trust in the healthcare system. When politicians, who are expected to be representatives of the people, opt for foreign medical treatment, it sends a message that the local healthcare system is inadequate. This undermines the confidence of citizens in the system and perpetuates the belief that quality healthcare is only available abroad. Thirdly, the preferential treatment given to politicians reinforces a culture of entitlement and impunity. It sets a precedent that politicians are above the law and entitled to privileges not accessible to the general public. This further widens the gap between the political elite and ordinary citizens, fostering resentment and disillusionment among the population.
It is, therefore, necessary to address the implications of medical expense payments for Nepali politicians in foreign countries, several steps can be taken. The most important is to strengthen the local healthcare system. The government should prioritise investment in healthcare infrastructure, equipment, and human resources to improve the quality and accessibility of healthcare services within the country. Introducing comprehensive healthcare reforms, such as universal health coverage, can help reduce the burden of out-of-pocket expenditure for Nepali citizens and ensure equitable access to healthcare services.
There is an urgent need to strictly follow guidelines and regulations regarding medical expense payments for politicians and on top of it strict compliance without exception. Transparent reporting and oversight mechanisms should be put in place to ensure accountability and prevent misuse of public funds. Instead of seeking treatment abroad, efforts should be made to promote medical tourism within Nepal. This would not only retain healthcare expenditure within the country but also contribute to the local economy and healthcare infrastructure development.
Last but not the least, the practice of Nepali politicians seeking medical treatment abroad at the expense of the state has significant implications for the out-of-pocket expenditure of Nepali citizens and the overall healthcare system. It highlights the need for a more equitable distribution of healthcare resources and the importance of strengthening the local healthcare infrastructure. By addressing these issues, Nepal can work towards providing affordable and accessible healthcare for all its citizens, irrespective of their social or political status.
(Dr. Lohani is the clinical director at the Nepal Drug and Poison Information Centre. firstname.lastname@example.org)