Sehat Sahulat Programme (SSP) is one the of the flagship welfare programme of the PTI government. After seeing the success in KP where SSP was rolled out in phases, Punjab, GB, Azad Kashmir and federal governments are kicking off the ambitious plan to cover their respective regions within a year. For details read, “Sehat Sahulat Programme" published on 16th July 2021.
Introducing a health insurance plan all-in-one-go in Punjab and other areas where population is 4 to 5 times of KP (there too, it took a few years for the program to reach full coverage) will have its own challenges. Ideally, it should be done in phases; but it seems that the government is short on time as elections are approaching and all the overly ambitions and radical programs such SSP and KPP are being expedited.
In the case of SSP in Punjab, the province can be fully covered before elections. But for that, it is advisable for the Punjab government to carry it out in clusters and unlike KP, should not keep all its eggs in State Life Insurance company’s (SLIC) basket. The government of Punjab has shortlisted three companies or consortium of companies for rolling out the insurance plan.
Here the government should involve the private sector along with SLIC to reach out the large population of Punjab in a short period. One reason for having private participation is to not cannibalize the existing footprint of private companies in the health insurance segment. Prior to KP SSP, SLIC had little to no experience in health insurance. Now SLIC portfolio of health is almost similar in size of combining all the private companies who have an organic growth of a few decades in a limited private corporate market.
The business of private firms in KP is limited and SLIC’s penetration there did not really cannibalize the private business. But Punjab is a big market and with government giving free health insurance cover of Rs8-10 lakh to each family, many customers of private companies may move away to the government. This risk of eroding private sector should be addressed.
The other element of having more than one player to cover the large pool of population and multiple divisions is to ensure the right service delivery to the end consumer. SLIC is building its capacity in the health and is doing a fine job in KP, but the government should not test its limits. Having competition in service delivery is healthy and that to keep all the players on their toes to get future business as the insurance companies’ contract would be for three years.
Meanwhile, the tentative launch date given by the provincial government for this scheme is overly ambitious as government aims to gain political mileage before the elections. It is pertinent to note that through this scheme the government is planning to double the total insured population of Pakistan. There could be operational glitches and technical capacity challenges in the implementation phase. The risk is of facilities deficiency and the end beneficiaries may not get the full intended service.
A prudent approach could have been to launch this scheme in 2 to 3 phases with a gap of six months between each phase. But with election considerations, an alternate strategy could be to involve both public and private sectors in partnership in one way or the other – either by dividing clusters between different companies or by private sector companies subletting their services to SLIC. This may bring synergies and government may be able to take benefit from experience and expertise of both private and public companies.
A recent and pertinent example can be presented in the form of ongoing COVID-19 vaccination campaign. The decision to involve both public and private sector hospitals has helped in covering large population swiftly in an organized way. Imagine the chaos had the government decided to dispense the vaccine through government hospitals only. Not only that would have resulted in longer queues and frequent instances of SOP violations, but it would have also taken a lot more effort and time to achieve the desired level of immunity in the masses.