Nepal's Health Insurance Program Faces Renewed Crisis Amidst Mounting Debt and Service Disruptions
Summary
Nepal's Health Insurance Program faces a renewed crisis due to mounting debt and service disruptions, with hospitals suspending services and the Health Insurance Board limiting OPD coverage.
Key Points
- Hospitals like Tribhuvan University Teaching Hospital and Sahid Gangalal National Heart Center have suspended services under the Health Insurance Program due to unpaid claims.
- The Health Insurance Board owes hospitals around 19 billion rupees and has limited OPD coverage to twenty-five thousand rupees under the one lakh scheme.
- 55 percent of insured citizens do not pay premiums, and many who do renew insurance only when ill, causing financial imbalance and adverse selection.
- The Board proposes reforms including mandatory formal sector inclusion, premium review, a single window for social security, and dedicated health tax funding to sustain the program.
