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Kathmandu, Feb 4: A discussion on the current state and future direction of the Health Insurance Board turned tense on Wednesday afternoon at the Prime Minister’s Office, as sharp differences surfaced between the Health Ministry and the Finance Ministry.

The meeting was attended by the prime minister, the chief secretary, officials from the National Planning Commission, the Health Ministry, the Health Insurance Board, and other agencies. Health Insurance Board Executive Director Dr Krishna Prasad Paudel presented an overview of the programme and its financial strain.

Dr Paudel said the government was required to pay service providers Rs 23.81 billion in the last fiscal year, but the board managed to clear only Rs 12.81 billion. Around Rs 11 billion remains unpaid in fiscal year 2024/25. For the current fiscal year, the government allocated Rs 10 billion, while insurance premiums generated Rs 3.73 billion. The entire state subsidy for this year has already been used to clear last year’s dues.

By mid-October, the board had liabilities of Rs 6.52 billion to service providers. Citizens are using insurance services worth an average of Rs 80 million each day, pushing monthly obligations above Rs 2.4 billion. By the end of the current fiscal year, the board needs to secure about Rs 26.52 billion, but funding sources remain uncertain. Due to delayed payments, several large hospitals have already stopped providing insurance services.

Finance Secretary Ghanashyam Upadhyay responded sharply, saying the presentation described the crisis well but failed to offer a clear future plan. He blamed policy failure and indifference within the Health Ministry for the situation and accused the board of taking populist decisions without informing the Finance Ministry, only to present unresolved problems later.

Health Minister Dr Sudha Sharma countered that an immediate Rs 11 billion is needed to clear payments, faulted budget handling by the Finance Ministry, and said services promised in the budget cannot be cut. She pressed for more funding, earmarking tobacco tax for health, enforcing the insurance law, and system-wide reforms, including reinsurance for major risks.

Finance Secretary Ghanashyam Upadhyay accused the Health Ministry of ignoring repeated insurance reform reports and pushing unchecked free coverage for seniors and target groups. He said revising benefits and diverting part of old age allowances to insurance could raise Rs 4 to 5 billion quickly. He flagged misuse in private hospitals, costly tests, and drug wastage, urging policy reform before seeking funds, and ruled out extra budget support for now.

People’s News Monitoring Service