Kathmandu, March 16: The Health Insurance Reform Recommendation Task Force Report 2081 BS has been made public. The report provides short-term, medium-term, and long-term recommendations for improving the health insurance system.
At a press conference organized by the Ministry of Health and Population, the report was officially released in the presence of Health Minister Pradeep Paudel, Secretaries Dr. Bikash Devkota and Hari Prasad Mainali, and Executive Director of the Health Insurance Board, Dr. Raghunath Kafle, among others.
The report focuses on making health insurance more effective and accessible to all citizens, ensuring quality and affordable services, maintaining good governance, achieving self-sustainability, and integrating health services under a unified system.
A nine-member Health Insurance Reform Recommendation Committee, led by Dr. Shambhu Acharya, was formed on October 13. The committee submitted its report to Health Minister Pradeep Paudel on January 3.
While unveiling the report, Minister Paudel reaffirmed the government’s commitment to organizing and expanding health insurance. “Every administrative level will now have a mandatory health insurance unit. Health insurance is a responsibility of all three levels of government, and their collective financial contributions must strengthen the insurance fund,” he stated.
Minister Paudel also suggested that taxes on sugar-based products, tobacco, alcohol, and pollution—which negatively impact public health—could be partially allocated directly to the health insurance fund. This, he said, would help reinforce the existing fund.
Expansion of Coverage: Increase the insurance coverage threshold to at least Rs 500,000 per person. Introduce premium and co-payment structures based on individuals’ financial capacity.
Integration with Free Health Services: Link free basic healthcare and emergency services with health insurance. Design premium packages that allow additional clinical services.
Flexible Premium Structures and Additional Benefits: Develop optional premium-based packages for those seeking extra health services. Establish clear guidelines and criteria for service providers.
Reorganization of the Health Insurance Board: Approve the board’s organizational structure and review the basic health service package. Implement automated systems to modernize operations. Expand insurance coverage for essential medical services.
Legal and Policy Integration: Create a unified law to integrate health programs across all three levels of government. Make insurance progressive, with annual premiums ranging from Rs 7,000 to Rs 15,000. Provide full subsidies for poor and vulnerable groups. Extend mandatory health insurance coverage to all government employees and formal sector workers.
10-Year National Health Insurance Goal: Achieve 100% household coverage and 90–100% population enrollment in health insurance by 2091 BS (2034 AD). The current coverage stands at 39% of households and 25% of the population.
The government aims to make health insurance mandatory for all citizens, ensuring that government employees and workers in the organized sector are enrolled through an official decision.
This initiative aligns with Nepal’s broader goal of universal health coverage, strengthening financial protection for citizens against medical expenses. #nepal #insurance
