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🇳🇵 Nepal /Health & Science

First OPD cuts and now private hospital services halted under health insurance scheme

From Kathmandu Post · () English

Summarized and contextualized by DistantNews.

At a glance

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  • Nepal's Health Insurance Board has halted outpatient care at private hospitals due to a growing financial burden, owing providers Rs18 billion.
  • This follows earlier cuts to outpatient service limits and reimbursement issues that led state-run hospitals to provide only partial services.
  • Patients who purchased the policy feel cheated as they are denied services or forced to pay out-of-pocket, eroding public trust in the government's health coverage commitments.

Nepal's Health Insurance Board has suspended outpatient services at private hospitals, citing a severe financial crisis. The board owes healthcare providers approximately Rs18 billion for services rendered until mid-May, with an additional Rs20 million in liabilities accumulating daily. This decision follows earlier reductions in outpatient service ceilings and widespread reimbursement delays that have already impacted services at major state-run hospitals.

What can we do when the government goes back on its commitments it made while selling the policy?

— Dr Krishna Man ShakyaA public health expert commenting on the government's breach of commitment.

Public health experts and patients express dismay over the government's actions, which they view as a betrayal of trust. "What can we do when the government goes back on its commitments it made while selling the policy?" questioned Dr. Krishna Man Shakya, a public health expert. He added that such decisions erode public confidence and undermine the goal of universal health coverage.

The decision aims to ease the growing financial crisis faced by the board.

— Bikesh MallaInformation officer at the Health Insurance Board explaining the reason for halting outpatient care at private hospitals.

Patients who subscribed to the government's health insurance policy report facing discrimination. They describe being denied services, including surgeries, forced to wait months for appointments, and compelled to pay for lab tests and medicines that should be covered. Hundreds of thousands of policyholders have been affected by these frequent changes, leading to accusations of being cheated by the government.

How can we achieve universal health coverage by denying services for which the public has paid in advance?

— Dr Krishna Man ShakyaA public health expert questioning the government's strategy towards universal health coverage.
DistantNews Editorial

Originally published by Kathmandu Post. Summarized and contextualized by our editorial team with added local perspective. Read our editorial standards.

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