Minister Poudel Proposes 40 Billion Budget and One-Door System for Health Insurance Reform

Kathmandu – Health and Population Minister Pradeep Poudel has outlined a plan to reform Nepal’s health insurance program with a proposed budget of NPR 40 billion and the implementation of a one-door system to streamline resources and improve service delivery.

Addressing questions raised in the Legislative Parliament by Member of Parliament Dr. Sunil Sharma, Minister Poudel acknowledged that the health insurance program faces financial strain due to outstanding arrears and inadequate resources. He stated that a report prepared by the Insurance Reform Suggestion Task Force has provided a detailed action plan to make the program sustainable.

Seeking Additional Resources

Minister Poudel emphasized the need for NPR 40 billion to cover previous arrears and improve health insurance services. He proposed securing this amount either through direct budget allocation or by identifying new revenue sources. He also suggested that organizing resources through a one-door system, based on citizen contributions, would help stabilize the program.

“We don’t have an alternative to health insurance,” Poudel said, highlighting that the program is viable if resources are properly managed. He noted that under the proposed reforms, the insurance fund could provide up to NPR 500,000 for citizens’ medical treatment if the three levels of government—federal, provincial, and local—consolidate their health-related spending into the health insurance fund.

Strengthening the Insurance Fund

Minister Poudel proposed integrating scattered health programs into the health insurance fund and increasing citizen contributions through a progressive premium system. He suggested that employees receiving state salaries should contribute 2% to the fund, with private sector workers following the same model.

To further strengthen the fund, Poudel proposed transferring 50% of the social responsibility tax to the insurance fund and allocating a small percentage of taxes on petrol, diesel, gas, and mobile recharge cards to the fund. He also suggested increasing the health tax fund from NPR 6 billion to NPR 18 billion.

Preventing Misuse and Ensuring Accountability

Minister Poudel stressed the importance of preventing misuse of health insurance funds. He proposed introducing a co-payment system and tightening legal provisions to curb false claims. “If misuse can be prevented, even a 10% contribution from citizens may not be necessary,” he said, adding that action would be taken against those providing unnecessary treatment.

Minister Poudel concluded by expressing confidence in the proposed reforms and thanked the parliament for their support in strengthening the health insurance system

Health Insurance Reform Report Made Public, Minister Paudel Plans to Strengthen Insurance Fund