The launch of the Sehat Sahulat Program (SSP) in Punjab has stirred the political debate quite a lot. The incumbent government, which had its popularity in turmoil because of the rising inflation, was desperately looking for a segue, and the SSP seems to have afforded one.
The launch of the Sehat Sahulat Card was covered extensively by the local media. We at the Global Village Space (GVS) also published a piece on SSP in our February issue and debated the topic with political commentators and news journalists of the country.
The PTI government launched the Sehat Sahulat Program in Punjab on the 26 of March 2021 from DG Khan and has experienced a very rapid expansion since, especially in 2022. Since the start of 2022, PTI has been very proactive in spreading its universal health coverage system.
On the 1st of January, the health card was launched in Lahore, and then on the 20th of the same month, Rawalpindi saw the launch of the universal card. In the month of February, Bahawalpur, Faisalabad, and Multan were added to the program, bringing nearly 18.64 families under its coverage.
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According to the data available to us, presently, the SSP covers seven out of nine districts in Punjab and approximately 86 percent of the total families in Punjab, and by the 31st March, through its inauguration in Sargodha, 100 percent of the population of Punjab would come under the umbrella of SSP. With its launch in Gujranwala and Sargodha, the SSP would cover 29.98 million families and approximately a population of 110 million people.
The launch of SSP was started in South Punjab, which has been long considered as neglected and very underdeveloped. PTI marked a change in trend with its launch of the SSP in South Punjab by characterizing a shift away from the Lahore-centric development. The universal health coverage already covers the Islamabad Capital Territory, KP (Khyber Pakhtunkhwa), GB (Gilgit Baltistan), and AJK (Azad Jammu Kashmir).
Under the health card, an aid of only one million would be given to the families per year and this aid would only cover for the indoor operations – all types of major ailments, treatment of chronic diseases – and not for outdoor treatments which do not require the patients to be admitted into the hospital.
This was a major development in a country in which approximately 40 percent of the population is below the poverty line, meaning that more than one-third of the population earns less than $3.2 per day.
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In 2020 alone, more than 2 million people fell below the poverty line, with the pandemic and rising inflation threatening to push millions more into poverty. With its launch, the health scheme started to produce a positive impact on human lives as it afforded access to basic healthcare to the entirety of the population in Punjab.
The eligibility criteria for the SSP in Punjab requires one to be a permanent resident of the province. All disabled and transgender registered with NADRA are also given access to this health care system. The healthcare facility has not yet expanded to Sindh or Baluchistan. While Sindh has shown no interest in the healthcare facility, Baluchistan might still be persuaded to become part of this program.
The feat of the SSP was possible only because of the public-private partnership between the government and private hospitals. Figures shared by the SSP program reveal that till now, more than 560 hospitals have joined the program, and more than 700,000 indoor admissions have taken place as a direct result of this initiative.
Hospitals have now started receiving a large volume of patients and are generating more revenue. The government has set aside Rs 450 billion for the Sehat Sahulat Program to provide good healthcare facilities at subsidized rates.
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However, the healthcare facility needs to be supported with a proper health governance policy. Reports have arisen that reveal the efficacy of the SSP, and loopholes within the structure have started to emerge. Although access to basic healthcare needs to be subsidized, the implementation of the system far exceeds beyond monetary facilitation.
The government needs to put in place a supporting structure that supports the working of the SSP. The government needs to ensure that any patient who requests indoor admission is granted one and that hospitals do take in patients who come to avail their services under the Sehat Sahulat Program.
Despite reforms and improvement claims in public sector hospitals, 78 percent of patients got treatment in private hospitals under the KP Sehat Card program, which is extremely counterproductive because all the subsidies that the patients are getting under the SSP would be expended in a private hospital which charges exponentially more than the public hospitals.
The health department should enable the public sector hospitals to attract patients and generate income for its own institutions. Till now, such efforts have proved futile as the private sector draws the major chunk. Unless the PTI government addresses this issue, it risks the program’s success and performance.
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Although there is a lot of promise in the idea of universal healthcare facilities, the government needs to assess its policy failures in the implementation of this scheme. If the Sehat Card was such a game-changer, PTI wouldn’t have witnessed such a loss in the local body election in KP. PTI’s loss in KP reflects the lapses in policy implementation by the government and calls for immediate action.