Health Insurance

Introduction to Health Insurance

It's a truth that we can't completely rid our lives of the dangers and uncertainties that come with living, but we can protect ourselves and others we care about from the worst of the consequences by purchasing insurance. Every person in Nepal is guaranteed access to free primary healthcare under the Interim Constitution adopted in 2007. However, the truth is far different. There is a huge gap between urban (85.9%) and rural (59.9%) Nepalese populations' access to health services within 30 minutes. Only 61.8% of households in Nepal enjoy this luxury. Urgent population-level measures are required to remove obstacles to health care. With the release of the National Health Insurance Policy in 2013, the government of Nepal has recently (February 2015) constituted the Social Health Security Development Committee as a legal framework to begin implementing a social health security system (SHS). Despite ongoing difficulties with funding, the program has made strides toward its goal of expanding access to health care for the country's poor and disenfranchised, as well as those living in rural and other hard-to-reach locations.

An integral means toward accomplishing this goal in Nepal is the introduction of health insurance. A long time ago, an attempt was made to provide health insurance on a community basis. There are a number of obstacles that must be overcome before social health insurance can be fully implemented, bringing about health fairness and establishing universal coverage. Different health insurance plans have been tried and tested throughout history with varying degrees of success. Disappointment with the program as a whole can lead to lower enrolment and less use of services, which can lead to the program's demise.

The purpose of life and health insurance is to help the insured and their loved ones financially in the event of the insured's death or serious illness. The insured pays a premium to the insurance company in exchange for the promise that the money will be paid out in the event of a specified calamity. The assistance is given in the form of reimbursement for medical costs. Nepal has achieved great strides in the area of medicine in recent years. at a minimum, each Village should have a sub-health post. Development Committees (VDCs) were set up by the government in the 1990s. At around the same time, competition among private hospitals resulted from a sharp increase in supply, but unfortunately, treatment costs rose. Nonetheless, impoverished public hospitals failed to keep up, and an increasing number of patients opted instead for private hospitals. albeit it comes at a heavy price. bills incurred for medical care, burial costs, etc.

These days, people spend more money out of their own pockets on health care than is spent by the government and businesses combined. A one unexpected medical bill may put a family on the brink of bankruptcy. The right of every person to get medical treatment is vital, and universal health insurance is one way to ensure that right for everyone. Because of the government's ability to negotiate lower prices for goods and services, universal health care insurance can be implemented; however, this will need a substantial redesign of the present system. For any plan to work in Nepal, it must be adapted to the specifics of the country's situation.

Historical Background of Health Insurance in Nepal

In 1976, the United Mission to Nepal (UMN) launched the Lalitpur Medical Insurance Scheme in Ashrang, which was eventually expanded to cover more healthcare institutions throughout Nepal. In 2003, the government began funding a community-based health insurance program in two districts.

in 2005/06, it grew to include four new districts. In 2014, the government of Nepal established a policy to establish a universal health care system. The government of Nepal declared in overline FY 2071/72 that SHSP will be implemented in three districts (Kailali, Baglung, and Illam), however, enrolment did not begin until 25 Chaitra 2072 (07 April 2016) in Kailali and 15 Asar 2073 (22 March 2017) in Baglung and Illam (29 June 2016). There were 44 jurisdictions that got the benefit of this initiative up till the month of Chaitra in 2075. It is the ambition of the SHS program that they would be able to make a significant contribution toward Nepal's goal of moving from the list of Least Developed Countries to that of Middle-Income Developing Countries by the end of 2022. It is the goal of the Social Health Security Development Committee to roll out this service to all jurisdictions by the year 2020.