Vice-president announces unlimited health insurance from January 1

Vice President Dr Mohamed Jameel Ahmed has announced the government’s intention to introduce unlimited health insurance – ‘Husnuvaa Aasandha’ – on January 1.

Speaking at the launch of the government’s 100 day manifesto for the Ministry of Health, Jameel promised that the government’s pledge to provide a General Practitioner for every family would also be introduced in the new year.

One month on from the inauguration of President Abdulla Yameen, the government has produced similar 100 day roadmaps in a number of departments, including transport, immigration, and the security forces.

The current scheme – introduced under the administration of President Mohamed Nasheed – set a limit of MVR100,000 (US$6,485) annually for health services for all Maldivian nationals from hospitals and health centres operated by health corporations as well as private hospitals and clinics.

The initial scheme soon proved costlier than the government had envisioned, however, with hundreds reaching their entitlement limit within just a few months. Rocketing demand for services saw a reported 7000-8000 people using the scheme every day, at a cost of up to MVR3 million (US$194,552).

Caps were subsequently introduced on medicines and certain services provided in private clinics and hospitals as well as fees introduced for services at private clinics.

Vice President Jameel said last night called on the private sector to aid the government in providing affordable healthcare.

A recent World Bank report noted that a total of 276,033 citizens – around 84 percent of the population – had used the Aasandha service in its first year, representing about 2.8 percent of 2012’s GDP.

“Overall, a total of about 3.6 million transactions were recorded in the first year that represented an average 13.2 transactions per patient, a relatively high figure for a country with a predominantly young population and limited availability of medical service providers,” said the World Bank.

The same report – the ‘Maldives Development Update’  – described the country as “spending beyond its means”.

At present, public debt stands at an “unsustainable” 81 percent of GDP, the report stated projecting the debt will rise further to about 96 percent by 2015.

The World Bank saw the fiscal sustainability of the Aasandha scheme as its major challenge, offering a series of recommendations to achieve this.

“Substantive savings could be achieved without significantly compromising coverage and quality of services by re-designing the scheme with a focus on provider incentives.”

The World Bank went on to suggest that the bulk purchase of essential and generic drugs could reduce the costs of the scheme, as could tighter controls on overseas treatments.

Jameel has previously acknowledged that a lack services has forced many Maldivians to live abroad for medical purposes, pledging chemotherapy in the public Indira Ghandi Memorial Hospital, as well as nine dialysis units.

He has also promised that screening to diagnose cervical cancer would be introduced under a government insurance scheme.

Jameel had previously stated that the specifics of the government’s health proposals would begin “as soon as we get the budget for it”. The details of the 2014 budget continue to be discussed in the Majlis, with the final draft due to be presented to the full chamber at the end of the week.

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