Access To Healthcare

Minister for Health and Population Pradip Poudel has said that hospitals can no longer cite a lack of medicines as an excuse for failing to provide services under the health insurance scheme. This step aims to ensure that patients have access to affordable medicines.  Requiring every hospital to stock the government-allocated medicines to be used to improve the efficiency of the health in-surance programme is a commendable initiative. The ministry has been providing 98 types of medicines for both communicable and non-communicable diseases free of cost from district hos-pitals and primary health care centres. As per the policy, hospitals providing services under the health insurance scheme should mandatorily keep all the medicines as instructed by the Health Insurance Board. 

However, many hospitals and primary healthcare centres are sometimes found to be reluctant to provide the prescribed medicines, citing shortages or other problems. In such a case, the policies must also include rigorous monitoring provisions along with the enforcement of the hospital’s accountability. A continuing issue in the healthcare sector is the scarcity of medical professionals in district hospitals. Although the health minister has accepted that doctors like to serve in urban areas instead of rural ones, forcing them to work in specific locations is not a sustainable ap-proach. 

The fact that many medical professionals are not interested in serving in remote areas is attributed to a range of reasons, including lack of infrastructure, no growth opportunities, and inadequate rewards. If the intention is to get the medical practitioners to stay in the rural settings, the gov-ernment has to come out with specific incentives such as growth opportunities, more incentives, and a better environment for working. Only a comprehensive approach can be the adequate solu-tion for this problem. Implementing health insurance is just one part of the more general problem that has to do with the healthcare system in Nepal. Though public healthcare efforts are supposed to increase the accessibility and affordability of medical care, not all citizens can take advantage of good healthcare services. 

Hospitals usually justify this situation by the fact that they do not get enough resources, there are delays in reimbursement, and the infrastructure is incapable of covering all the needs, which are the reasons for the schemes to be incompletely applied. Deviating from a mere directive issuance, the health minister and other respective entities need to perform thorough assessments to detect the problems faced by the health institutions and find functional solutions. For the programme to be successful, regular inspections, transparent audits, and constant patient and healthcare provid-er feedback should be taken by the concerned authorities time and again.

Instead of making rhetorical announcements, the responsibility of the concerned authorities is to develop realistic approaches to resolving these problems. Openness and transparency, as well as public participation and strategic improvements in the healthcare system, will determine the suc-cess of health insurance schemes. The government should make the healthcare system more peo-ple and patient-oriented by truly delivering quality and productive services. The government-run health institutions should be well-equipped and easily accessible to guarantee that every citizen's right to health is upheld as a fundamental right.