Claims Without Resources

It has become customary for the political parties to roll out popular plans and programmes ahead of elections. They do so even though the state lacks the necessary resources to fulfill their lofty pledges. They introduce such measures solely to woo voters. These unrealistic commitments are quickly sidelined once the election cycle ends. The onus lies with the parties that form the post-election government. Yet they rarely take institutional initiatives to implement their commitments. The parties that lose the elections or remain outside the new government show little interest in implementing their manifestos.

However, voters, experts and the media often keep an eye on parties’ pledges and attempt to hold them accountable for their words and actions. It is pertinent for parties to accord priority to sectors such as health, education, employment, social security, development projects and climate change, among others. A news report of this daily, the other day, dwelt upon the parties’ commitment to the health sector. Their manifestos contain similar promises for the development of health services, especially for the medical treatment of people who lack financial means. They have committed to providing free health services, health insurance, and other fundamental health rights. Yet there is little or no attention paid to their feasibility and effective implementation of these commitments. 

Devising programmes without a strong financial base leads to failure. Health insurance is a case in point. It is an essential programme to ensure free medical services to the people, with the state bearing a substantial amount of the expenses. However, it is now on the verge of collapse due to financial shortages. Several hospitals have run out of resources to continue the insurance scheme. The Health Insurance Board owes billions of rupees to the major hospitals. The Ministry of Health and Population has expressed its inability to clear the outstanding dues. As a result, some hospitals have suspended insurance services while others have decided to reduce the insurance coverage from the existing Rs. 100,000 to Rs. 25,000. 

Contrary to ground reality, the political parties contesting the House of Representatives elections are competing to make lofty promises. The Nepali Congress has pledged to expand health insurance coverage from the current Rs. 100,000 to Rs. 1 million, while the Rastriya Swatantra Party (RSP) has introduced the concept of ‘100 per cent insurance', which aims to provide comprehensive and free health services through health insurance. In the country where the government tightens its belt to manage general expenditures, making pledges without adequate budgetary support risks creating crises in service-oriented programmes. The health insurance scheme is now reeling from a fund crunch due to this very factor. 

The World Health Organisation prescribes allocating at least 10 per cent of the total budget to the health sector. Nepal has been unable to meet this standard. The government at the time increased the health sector budget to 6.5 per cent during the COVID-19 pandemic. The great irony is that parties do little to strengthen the health sector through budgetary allocation while in power. They sell empty promises ahead of the elections to tip the balance in their favour. Now the time has come for them to be realistic and explore common ground for the development of health, education and employment sectors. It is imperative to pool resources to implement current health schemes before unveiling ambitious new ones.