RIZWAN GHANI
IN his AK Universal Health coverage scheme speech, PM said Insaf Health Card is a great service for the poor despite lack of resources. He said SKMH is great help for the cancer patients and praised Scandinavian welfare system including Denmark, Norway and Sweden. But details will show that like Thatcher, PM is bringing changes in our public services which have failed in the UK, institutionalized mega corruption and ended expertise so PM and his team must be stopped to save Pakistan. He said that 350 hospitals nationwide will provide health-care services on IHC in which only 40 are public while 90% (310) are private. There is one million rupee annual ceiling on each card per year. By introducing IHC, PM has legally forced state to pay public funds to private setups for 12 lac AK people for eternity. Payment of tax money through IHC merits to be scrapped by the Supreme Court because it is constitutional responsibility of the government to provide basic health services to the public. Government should also be obliged to use national identity card to end allied costs and corruption. Then governments of KP and Punjab should be asked to give complete details of amount spent on IHC since start of schemes in both provinces. It will expose beneficiaries, amount and extent of damage to national exchequer. The basic idea is to show the judges, public and PM how tax money is being gifted to private businesses instead of building healthcare systems at district and tehsil levels, privatizing allied healthcare jobs in public sector and providing cheap healthcare. Now it is easier to make sense of astronomical increase in healthcare cost. The removal of federal health advisors due to drug price increase scandal was more about self-preservation than public welfare because PM as Minister-in-Charge of National Health Services, Regulations and Coordination is keeping drug price control under health ministry for legal protection of self and health SAPMs. The drug prices continue to increase by 400-800% while giving public funds to private hospitals with approval of PM which is difficult to challenge in courts due to inbuilt legal protections. PM makes it a point to remind the country that he understands the West best. Then he should also be aware of sophisticated style of western corruption in his government because majority of his team, like him, is also foreign educated and well versed with western systems of healthcare, law and free market. BMJ published UK report of cash for referring the patients to private hospitals involving money and pillars of British medical establishment. The Economist ran a $272bn swindle report in American healthcare program meant for the poor and disabled. It is only matter of time that IHC will make news like other mega scandals of this government. Johnson government and his “doormat” health ministers are also facing public wrath, media backlash and legal scrutiny amidst reports of mega corruption in Covid-19 related spending, policies and scandals of favouritism. Lawsuits are being filed to discover how and by whom the money was spent. The government is using the pandemic to shift the boundaries between public and private provision, restructure public health and pass lucrative contracts to favourites. Independent audit report of Pakistan’s $8bn Covid-19 Stimulus Package should also be made public. If PM is trying to adopt new public management system with leading role of private sector, the 40 years of UK history shows that it is complete failure. Adopted by the Conservative and New Labour governments of the 1990s and 2000s, NPM reforms failed in healthcare, schools and elderly care. Record shows that the measure of success in terms of “doing more with less” through private sector instead of public resulted in permanent loss of jobs, knowledge and indebtedness. Pakistan can end its debt, create jobs and revive economy if it restores public control of healthcare, education, transport, energy and economy. Reportedly, senior consultants from one UK consulting group were being paid as much as £6,250 a day to work on test and trace. That means in just one week they take home what nurses are paid in a year. There is growing evidence that ministries and bureaucracy are cost effective and efficient than private consultants in running the countries. It is about time cost, pays and perks of autonomous healthcare, private advisors, consultants and autonomous healthcare costing national exchequer. In Norway, the public pension increases every year. In 2019, country’s inward stock stood at $167bn despite maintaining strict labour laws, long list of restrictions on buying of national assets including acquisition of cultivable land, water, real estate, ban on long term leases, only 10% of government shares in energy sector. It is trust that brings investors to the country without compromising constitutional and legal protections of labour and local resources. Norway is 9/180 in doing ease of business and 7/180 on Transparency Corruption Index. The policies benefit public welfare than private individuals. —The writer is senior political analyst based in Islamabad.
