Government hospital insurance cuts force patients to pay for private care

Thousands of Nepalis are facing significant financial burdens and health risks as the government's decision to discontinue outpatient care under the health insurance scheme at private hospitals forces them to seek expensive private treatment. This policy reversal contradicts the commitments made when premiums were collected, leaving patients who paid for coverage in a precarious situation.

Sanu Maiya Dhakal, a resident of Kathmandu, experienced severe back pain and sought treatment at Nepal Medical College, a referral hospital under the health insurance scheme. However, she was denied outpatient services. After waiting hours at Bir Hospital, she was advised to get an MRI, which she had to undergo at a private facility for Rs18,000, double the cost at Bir Hospital. The report revealed a lumbar spine problem requiring emergency surgery, but her family was asked to arrange medicine worth Rs40,000, receiving only Rs3,500 worth from the hospital pharmacy under the scheme.

Similarly, Ashmita Neupane suffered from severe headaches and blurred vision. She was advised to get an MRI urgently due to a suspected swollen brain vein. After facing delays at Tribhuvan University Teaching Hospital and Bir Hospital for the MRI, she was still awaiting the scan at Tilganga Eye Hospital, which lacks the service. The article highlights that had the government not stopped outpatient care at private centers, Dhakal would have avoided long waits, exorbitant MRI costs, and significant out-of-pocket expenses for medication.

The situation underscores a growing crisis for patients who relied on the health insurance scheme for accessible and affordable care. The government's decision has effectively pushed many, particularly those from poor and marginalized groups, towards private healthcare providers, incurring costs far beyond their means and potentially compromising their health due to treatment delays.

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I waited hours for a ticket and a few hours to see a doctor at Bir Hospital. The doctor asked me to come with a Magnetic Resonance Imaging (MRI) report immediately, but I am told that I have to wait until September to get it done in the hospital.