Prime Minister Imran Khan has launched a countrywide Sehat Insaf Card scheme to provide free medical treatment to about 80 million people. The Pakistan Tehreek-i-Insaf (PTI) has pinned high hopes on the health insurance scheme, which paved the way for an unprecedented two-thirds majority in Khyber Pakhtunkhwa in the last election.

The card, which falls under the PTI’s Sehat Sahulat Programme, was part of a health insurance scheme launched by the party in Khyber Pakhtunkhwa in 2016. It was first issued to half of all households, then to 69pc of poor households and it made a big difference in the last election. Under the scheme, over 80 million people ─ or 10.5 million households below the poverty line ─ will receive free medical treatment worth Rs720,000 in private or state-owned hospitals. Around 15m people will receive the cards over the next two years. Over 150 hospitals will provide free treatment ─ including procedures such as angioplasty, brain surgery, and cancer ─ under the facility. The Sehat Insaf Card will cover treatment of all ailments except transplants.

According to the government, the scheme will initially cover the Punjab, Gilgit Baltistan, Islamabad, erstwhile Federally Administered Tribal Areas and Islamabad. Each family in the tribal districts will be provided with the cards, whereas 85,000 families in Islamabad would benefit from it. Each card holder will also be provided with the cost of transport up to Rs1,000 for each hospital visit. Launching the scheme in Islamabad, Prime Minister Imran Khan noted that underprivileged or working class individuals often have difficulty subsisting on their salaries and meeting their household expenses. “When there’s an illness, their entire budget is upset. Research has shown that many households struggle financially due to illness since they are already surviving at subsistence level. When a member of an underprivileged household falls ill, his family has to sell everything in order to be able to afford treatment,” he explained.

A National Steering Committee, comprising representatives from the federal, provincial and regional health departments will also be formed to review the performance of the programme. As part of its poverty alleviation drive across Pakistan’s poorest districts, the PTI in its manifesto had stated that it would “upscale the Sehat Insaf Card Programme across Pakistan to provide access to quality healthcare to citizens.” In case of an accidental death, Rs10,000 will be given to the card holder’s family to cover the costs of the funeral. The Punjab government will provide the card to around 10 million people. In the final stage, it will be provided to the population living below the poverty line in all provinces. The Benazir Income Support Programme (BISP) data is being used for the registration of the families for it. The programme, to be eventually expanded to the whole country, will remain limited to the Thar area in Sindh initially. The beneficiaries can get medical treatment for diseases, like heart, burn injuries, diabetes, dialysis, cancer, neurosurgical and emergency treatment, at the designated hospitals. The government plans to provide health cards to all citizens by 2030.

The card was the KP government’s flagship health insurance programme. It allowed households to utilise up to Rs540,000 per year, for medical treatment and medicines, at public and private hospitals across the province. So, the poorest person in KP, without a single rupee in hand, can be treated at the finest private hospital in Peshawar, just like any fee-paying patient. The insurance also pays patients lost wages, and in case of referrals from outside Peshawar, travelling money. Premiums are surprisingly low. Currently, the KP government pays the insurance company just Rs1,500 a year per household covered. However, it will have to rise a bit, as the insurance company is losing money on the deal.

A similar scheme was also launched by the PML-N government in 2016. However, Information Minister Fawad Chaudhry has rejected the claim of the PML-N that the Insaf Health Card scheme was a copy of its project. In a tweet, he said the PML-N had actually copied the scheme launched by the Pakistan Tehreek-i-Insaf (PTI) government in Khyber Pakhtunkhwa in November 2015. “The PML-N copied the scheme but failed to achieve its target,” he added.

According to a UNICEF report, more than 70pc of the total population in Pakistan does not have access to safe drinking water and more than 70,000 children die every year due to diarrhoea and other diseases related to unsafe water and poor sanitation facilities. Over 80pc of all diseases in Pakistan are caused by contaminated water, which in turn, causes 40pc of deaths in the country, says a report by the Pakistan Council of Scientific and Industrial Research Laboratories. The government will have to take urgent measures to provide safe drinking water to save people from diseases and reduce the burden on hospitals.

The new health scheme has been welcomed at all levels. The PTI government has taken difficult decisions after coming to power, which have badly impacted the average households in Pakistan. With a poor health system in the country and the growing rise in treatment costs, the pressure on an average Pakistani family increases, especially in case of an illness. The scheme has been launched to counter the problem and make their lives more manageable. The great aspect of the initiative is that it has already been tested out in KP during the last PTI tenure. The only treatment that is not available for the card holders is a transplant.

The health insurance card is a great initiative of the government. However, there are few questions about it. Public welfare schemes in the past have been used by the ruling parties to achieve their petty political goals. There is a need to ensure that the health programme remains apolitical and is not used to advance the cause of the PTI. Besides, the government should improve the existing infrastructure to provide more facilities to the general public at hospitals, which lack medicines, equipment and beds.