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By Sanniah Hassan
Maintaining good mental and physical health is a substantial part of optimal healthcare, access to which should be an essential concern of those in power, and although, a system to ensure the provision of basic amenities should be at the helm of any good governance, it usually is not.
There can be various reasons behind this, but most commonly this is determined by the GDP and HDI of any developing country. For countries like ours, generally considered to be "least" developed, decisions such as healthcare are predominantly made on the basis of the Gross Domestic Product (GDP) per capita and the Human Development Index (HDI). However, this is a step that can only be taken when the state leadership is focused on progress in the right direction. Although Pakistan is not among the "least" developed countries according to the World Population Review website, yet, we too are lacking a potent system to sustain facilities for people from all walks of life.
But first, what constitutes health care and why should it be accessible for all?
Healthcare refers to the provision of amenities that help to restore "physical, mental, or emotional well-being" by professionals trained for the purpose. Thereby, individuals belonging to this profession are known as healthcare providers, or "healthcare professionals", respectively, and are expected to play a major role in "improving access to quality health care". People in healthcare are also actively engaged in preventing disease while providing optimal care to families across the globe.
What is essential healthcare & what are the benefits of such programs?
G. L. Monekosso MD FRCP (ED) argued that essential healthcare constitutes all forms of healthcare programs from individual healthcare to family and community care. However, D. M. Eddy in "What care is ‘essential’? What services are ‘basic’"? argues that certain healthcare facilities should be accessible to all regardless of the individual's ability to afford such amenities, whereas, other facilities such as surgery or overnight stay can be charged as needed.
This then brings us to a point where we must consider the quality of healthcare and try to learn more about the cost of healthcare in Pakistan. Is it truly accessible for all? Or only a few, financially able people are able to afford the best treatments?
Eddy has argued that decision-makers should be strategically selected to decide about the benefits, the danger, and the cost of a medical facility. He further argued for the “ethical implications” of providing “different levels of care for different persons”.
This then brings us to a point where we must consider the quality of healthcare based on our financial and life circumstances often, compromising our health and quality of life. This dilemma when it persists in Pakistan raises a series of questions, the primary questions being, what is the cost of healthcare in Pakistan? And can people from all walks of life afford it?
Healthcare in Pakistan & the pros of getting medically insured
Since the start of the Covid-19 pandemic in Pakistan, in March 2020, hospitals and other medical care facilities across the country have raised the cost of basic medicines and treatments making it harder for the lower and middle classes to afford “specialized” treatments which may include surgical procedures, labor, and delivery, overnight stay, among others.
In early March of 2020 when Pakistan confirmed reports of some of its first cases of the then-novel Coronavirus (SARS-CoV-2/Covid-19), the cost of a simple 3-ply face mask surged from PKR 7/- to PKR 10/- even PKR 15/- in some cases. Hand sanitizers which were easily available at general and high-end grocery stores and supermarkets for a meager PKR 100/- to 150/- surged to approximately double the cost, resultantly being sold at PKR 300/- or “being sold out” forcing the troubled public to accept the undeserved price hike.
For a more detailed analysis of the early days of Covid-19 in Pakistan, click here.
Even the earliest PCR tests were available for PKR 7,500/- to PKR 8,000/- which was definitely not an easily accessible amount, especially for the poorer community which could barely afford to pay rent and provide 3 meals per day for their families.
What then, should a person do to make sure that he/she can afford even the medical care which is more high-end? Well, the answer is simple: Medical/Health insurance!
What is Medical Insurance?
Medical insurance or health insurance is a policy one acquires that enables one to cover medical and hospitalization expenses. According to investopedia.com, “Health insurance is a contract that requires an insurer to pay some or all of a person's healthcare costs in exchange for a premium. More specifically, health insurance typically pays for a medical, surgical, prescription drug, and sometimes dental expenses incurred by the insured.”
How to get insured?
This means that a person has to enter into a legal contract on the basis of a list of finalized clauses and pay a specific sum of money to ensure the agreement is binding between both parties, specifically the one seeking insurance and the company providing it.
A major benefit of getting medically insured in Pakistan is that in the likelihood of getting ill, a patient will not have to pay the hefty bills him/herself, but will be assisted by the company providing insurance to clear them. However, depending on the terms and conditions of a person’s specific contract, one may have to pay a certain amount of the bill from one’s own pocket. The percentage may vary; ideally, the patient will be expected to pay only twenty percent of the total bill, while the company handling your medical insurance will be expected to pay the remaining eighty percent of the amount.
Types of Health Insurance in Pakistan:
Another factor that can impact one's medical bills is the type of medical insurance one chooses. At the moment, “Life Insurance” companies in Pakistan offer four basic types of schemes to candidates hoping to get health insurance.
These types include:
- Individual insurance
- Family insurance
- Corporate insurance
- Accidental insurance
The first type of insurance as the name suggests is focused on one person, usually the person who signs the contract, and in the likelihood of an illness and/or accident, this type of insurance only covers the medical or hospital expenses for that one person.
The second type focuses on the individual as well as his/her immediate family usually wife and children. For this type of insurance, the cost of being insured is generally dependent on the number of people entering into the contract. So if the charges for one person are approximately PKR 2,500/- per month, for a family of four, these charges will be multiplied by four, bringing the total per month charges to PKR 10,000/-, respectively.
The cost for the second type may also vary depending on the terms and conditions of the policy.
For the third type, organizations or employers offer a sort of group “employee health insurance” as an added advantage of working for them. This type of insurance is usually outsourced, and charged on a monthly, bi-annual, and/or annual basis from the salaries of the employees. However, a downside to this type of insurance is that it only covers the cost of medical emergencies and/or regular, basic hospital visits. For instance, a company may provide insurance to its employee if he/she suffers from cardiac arrest but may not cover the cost of having a baby.
The last type which is the “Accidental” insurance, usually covers injuries or illnesses caused by an accident and not self-imposed injuries such as the ones caused by a suicide attempt (which is a crime as per Pakistani law and should be avoided. In case of suicidal tendencies, one should seek appropriate medical/emotional support). According to unofficial records, this type of insurance is allegedly the most popular in Pakistan.
How much does Health Insurance cost in Pakistan?
On average, the cost of medical health insurance can start as low as PKR 3,000/- and go up to as much as PKR 70,000/-, even more, depending on the plan one chooses for oneself or one's family, respectively.
For a more detailed overview of the Insurance Industry in Pakistan, check this document.
Some of the leading Medical/Health insurance companies in Pakistan include the following:
Jubilee Life Insurance
Normally associated with the brand of “happiness”, Jubilee provides low premium policies and easily comprehensible terms and conditions to its clients.
EFU Life Insurance
Known for being Pakistan’s largest insurance company, EFU offers its clients a “diverse portfolio” with the best value for the products.
Adamjee Insurance Company
This company is known for being Pakistan’s leading general insurance company and provides services ranging from motor to engineering, fire, and property to travel insurance, and others et cetera.
The company further boasts that its services are ISO 9001 certified.
Alfalah Insurance
Although relatively new in Pakistan, Alfalah insurance also offers a variety of services. Some of these are Motor, Property, Health, Energy, and Engineering insurance(s).
State Life Insurance Corporation of Pakistan
This insurance is a government-owned initiative and is at the top of insurance companies in Pakistan.
Although it primarily deals with individual plans, in certain cases, State Life Insurance has been known for offering group plans as well. Some of its popularly known schemes include the following:
- Whole Life Assurance
- Endowment Assurance
- Shad Abad Assurance
- Anticipated Endowment Assurance
- Jeevan Sathi Assurance
- Child Protection Assurance
- Wealth Builder Plan
- Supplementary Covers
- Health Care Plans
Remember to do your research and finalize the policy that fits your needs the best.
*This op-ed was originally published on Baaghi TV by the same writer.
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