Kathmandu, May 27
The government has curtailed health insurance services at private hospitals. Citing signs that the national health insurance programme is heading towards a serious crisis, the Health Insurance Board has decided to suspend all insurance-related services at private hospitals except emergency care.
In a notice published on Thursday, the Board said that due to the growing financial crisis, all health insurance services provided through private health institutions will remain suspended from May 29 until further notice.
The decision was made during a Board meeting held on May 24. With this move, insured citizens receiving OPD services, diagnostic tests, surgeries, medicines, and other regular treatments from hundreds of private hospitals and medical colleges affiliated with the programme across the country are likely to be affected. The Board, however, stated that emergency services will continue uninterrupted.
A total of 36 private health institutions have been operating under the health insurance programme.
Criticism has intensified over the government’s health insurance scheme, which was launched with the slogan of ensuring healthcare access for all citizens, but is now said to be on the verge of collapse due to severe financial mismanagement, unpaid dues, and administrative weaknesses. Sources say billions of rupees owed to private hospitals have remained unpaid for years, ultimately forcing the Board to reduce services under mounting pressure.
According to the Health Insurance Board, it still owes service providers Rs 16 billion.
Health sector experts say the government used the health insurance programme as a political tool for publicity but failed to pay serious attention to financial management, service quality, and sustainability. As a result, the very existence of the programme has now come under threat.
Private hospitals had long complained that the government failed to reimburse insurance payments, delayed claim settlements, and increased procedural hassles. Some hospitals had earlier warned that they would stop accepting insured patients. Now, with the Board itself suspending services, the insurance programme appears to have entered a phase of practical contraction.
