Unfortunately, the state of healthcare is in shambles in Pakistan. The idea of state provided healthcare is quite laughable in even developed countries like the United States, and even places where universal healthcare is provided it has its own problems and complexities and comes with its own issues.
State of Healthcare in Pakistan
In Pakistan itself Government Hospitals are overcrowded, the service provided is poor, private institutions are beyond the reach of the common man, all the while healthcare providers are underpaid. All in all, in a country where basic life necessities are difficult to attain, adequate healthcare in the case of illnesses or injuries is a very rare privilege.
Pakistan is amongst the lowest spenders on Healthcare, with only 5% of total government expenditure made out for it. Comparing to Iran which spends 22% of the total expenditure on health. More than half of Pakistan’s health expenditure is out of pocket and thus only the rich can access the scarce healthcare services available in the country.
According to PSLM 2019, 1 in 10 Pakistani households face catastrophic health expenditures and 0.5% have been driven below the poverty line due to these out of pocket expenditures. To the point that most Pakistanis of the lower-middle and middle-class refuse to seek healthcare until health issues reach a catastrophic phase.
To tackle this problem, Sehat Sahulat and other government health insurance services have been started. 80% of healthcare expenditure occurs in the private sector and so the government provides coverage for those that cannot afford healthcare. Cancer, Hepatitis, Kidney issues, among various other common problems are covered through these Sehat Sahulat cards and are a hopeful sign for the future of universal healthcare in Pakistan. Despite this, however, a better future is still a long-time coming.
These services are only available to those below the poverty line and only cover a certain spectrum of treatments. For those wary of the economic impact of healthcare problems in the future, looking for good health insurance is still the only option.
What is Health Insurance
In simple terms, Health Insurance is a way for a population to collectively afford healthcare costs. On the individual level, a person (or family head) pays a certain amount per month in return for the provider to pay for healthcare when it is needed.
The idea of accident insurance came to be in the US in the 19th century and the first notable instance of health insurance (or sickness coverage) is stated to occur in 1890.
Issues with Health Insurance
Of course, it is not as simple in the real world, there are numbers involved where the risk for a health emergency is calculated against the amount collected per pool and the rate is issued accordingly. Most health insurance companies are businesses and the point of a business is profit.
Thus a health insurance company unfortunately takes the capitalistic approach of charging higher premiums for more at-risk people (the elderly, and pensioners that can’t afford it) if they even offer coverage to them. Conversely, they like healthier clients that are less likely to have healthcare costs that might be more than the amount they pay per month.
Thus the point of health insurance is lost in the more common iterations of Health Insurance systems. For example, in the United States, Obamacare and Health Insurance policies have been an issue of contention as insurance rates and healthcare rates have both skyrocketed to insane levels.
This is so high that it can be gauged from various tales from the United States of people driving to Hospital with grievous injuries instead of calling ambulances due to the obscene cost of ambulance service.
Furthermore, the cost of essential pharmaceutical drugs like Insulin are sometimes ten times higher than that in countries with universal healthcare.
Even in countries where Universal Healthcare is available, there are long wait times for non-urgent surgeries and secondary and tertiary care is very difficult for people to obtain as there are a lot more people that need healthcare than those that pay enough taxes for the upkeep of the requisite healthcare infrastructure.
For example, in the US people that want certain kinds of surgeries can get them as long as they can pay for them. In Germany however, the time and procedure required to request and get the approval of certain medical procedures is prohibitively long and complicated.
In Conclusion
The complexities of Health Insurance (whether government provided or privately obtained) are immense on the macro-level. However, it is still a good choice to look towards investing in Health Insurance options early in life. Most Pakistanis do not account for future possible healthcare crises and then suffer later on in life.
Until an efficient universal healthcare system is implemented (one can always hope) It is best to get insured in some way or another to prevent a future catastrophe.
