The Health Ministry has suggested to Parliament’s Financial Committee that a co-payment be introduced to the Aasandha health care programme in order to mitigate the system’s spiralling costs.
Members of the committee were keen not to impose any fee on the public, however, and insisted that the focus of efforts should be on reducing costs and introducing controls that will reduce demand over time.
They were said to be open to the idea of charging a small fee for outpatient care. Aasandha Chairman Thorig Ali Luthufee told Miadhu recently that outpatient care had made up 65 percent of the costs incurred in the first three months.
In the same article, Luthufee noted that the programme did not have the standard controls required of such a scheme.
The cost of the system, introduced in January this year, has come under increasing criticism as the projected budget looks increasingly unrealistic. Ahmed Nazim, head of the Parliamentary Financial Committee recently described the system as a “hole in the government’s pocket”.
After yesterday’s meeting Nazim told Sun Online that the current Rf720 million (US$46million) budget for the scheme would run out by August or September.
The current costs of Rf3 million a day (US$200,000) would take the yearly cost to over Rf1billion (US$2.3 million).
The sustainability of the Aasandha scheme has become a particularly prominent issue as the government looks for ways to slash spending in order to reduce the budget deficit.
The International Monetary Fund (IMF) told the People’s Majlis last week that urgent measures should be taken to reduce expenditure, warning against further borrowing or printing of money.
Finance Minister Abdulla Jihad yesterday informed local newspaper Haveeru that the budget was being sent to Parliament for revision after it became clear that the government’s income would fall Rf2billion (around $130million) short of its anticipated expenditure this year.
Jihad warned that the country must avoid resorting to selling treasury bonds due to the country’s unsustainable levels of debt.
Members of the formerly ruling Maldivian Democratic Party (MDP) have criticised the current government’s financial policies. Former President Mohamed Nasheed argued that money has been wasted on police and military bonuses whilst the former Tourism Minister Mariyam Zulfa has argued that around $150 million has been lost after the government opted to change the way island lease extension payments were made.
Recent figures from the Maldives Inland Revenue Authority (MIRA) revealed that this lost revenue amounted to over Rf350million ($22million) in March alone.
Chairman of the National Social Protection Agency (NSPA) and State Minister of Home Affairs Thoriq Ali Luthfee had said previously in the local media that the Aasandha scheme “cannot continue to operate without interventions to control the demand.”
He alleged that the scheme was introduced “for political motives” without any proper planning.
Nazim echoed these concerns last week, telling Minivan News that the system had been “introduced in a rush” and had “gone horribly wrong.”
The Financial Committee is in the process of producing a report on Aasandha in an attempt to resolve these problems which Nazim reports as having resulted to “abuse on a massive scale”.
Regardless of opposition suspicions regarding the government’s long term intentions with the programme, however, Nazim has maintained his determination to continue the program on a more sustainable footing.
“Aashanda is here to stay”, said Nazim.
Thoriq, its not just about controlling the demand but also about making supply side more efficient. Being state minister for health why don't you have the foresight to see that? Maybe because you don't have the guts to tell all those doctors working in IGMH and at the same time owning and operating their own private clinics, that they can't do both? That they have to choose so that IGMH can actually focus on recruiting doctors even from overseas who will be there to see the patients at IGMH rather than forcing them to go see them at their own clinic for a considerable profit to the doctor but a significant cost to the patient? How did someone who has no idea about social protection and health insurance ended up as the Chairperson and State Minister for NSPA?!
Yet again, this regime put the interests of a few before the interest of the whole nation!
The new regime is faced with the same economic issues that faced the MDP government. The solutions are the same too, but this regime does not have the guts to implement any of the recommendations of the IMF.
The message is simple; live within your means or go bankrupt.