Free inpatient treatment for every family worth nearly US$5,680 in a year at a private or public hospital – this is what was announced by Pakistan’s government recently for inhabitants of its most-populous province, Punjab, with a target to cover its entire population by March.
Universal health care programs are fairly common in high-income countries, although the US, the world’s most advanced economy, is still a long way from adopting one. But for a low-middle-income country like Pakistan that depends heavily on loans from the International Monetary Fund and regional allies such as China and Saudi Arabia, free health care might sound like a pipe dream, particularly in the middle of a global pandemic.
And yet in Khyber Pakhtunkhwa province, in the northwestern part of the country on the border with Afghanistan, universal health care is already a reality. All citizens can get free treatment, including for accidents and emergencies, diabetes, cancer, hepatitis B and C, and heart and vascular disease.
The program is the initiative of Prime Minister Imran Khan, who came to power in 2018 after winning the national election promising tabdeeli, or change. In the past, governments in Pakistan tended to focus on grandiose construction projects, such as new expressways and subway lines, while paying lip service to more basic needs like nutrition and health care.
The neglect toward health care can be gauged in just a few statistics: 44 out of every 1,000 babies born in Pakistan die before completing their first year of life, while 74 per 1,000 will not live to see their first birthday. Some 32 million Pakistanis live with diabetes, ranking the country third in prevalence of the disease after India and China, and it ranks fifth in the world among high-burden countries for tuberculosis.
Even before Khan entered politics back in the 1990s, he was already known for his philanthropic efforts in the area of health care, using his fame as a cricket star to build a cancer hospital from charity donations where the majority of treatment is free. Khan frequently cites China as a role model for Pakistan and other Global South countries in the manner in which it has pulled 800 million people out of poverty.
Khan’s government has handled the Covid crisis significantly better than many regional and Western countries in terms of overall fatalities and disruption to day-to-day life. Pakistan has a population of 220 million and has experienced close to 29,000 deaths from Covid, while the US with a population of 320 million has suffered more than 850,000 deaths.
Last November Pakistan was placed No 1 in the world by The Economist in its normalcy index that measures responses toward pandemic-related restrictions through indicators such as retail, public transport, office occupancy and sports attendance.
Khan’s health care program is being rolled out in parallel with another government initiative, the Ehsaas program, which aims to turn Pakistan into a welfare state.
It encompasses more than 130 policies and programs including a monthly stipend and savings account for millions of destitute women, interest-fee loans, a network of homeless shelters that have been opening across the country, subsidies for families to buy essential food items and free cooked meals distributed on trucks, and a health and nutrition cash transfer program that aims to address stunting in children.
The yardstick by which many media pundits are judging the performance of Khan’s government is in relation to Pakistan’s current high inflation, often painting a skewed picture of economic haplessness.
While no doubt inflation is a massive challenge, it must be viewed in the context of the global increase in commodity prices that have helped fuel price increases, for which blame cannot be placed solely on domestic policymaking.
Although offering free hospital treatments won’t reduce the price of basic goods like motor fuel or sugar, it will cushion some of the financial burden for the masses.
Follow Hamad Ali on Twitter @Hamad_Ali