HEALTH INSURANCE SCHEME — A NECESSITY
The role of health insurance and information technology for the development of Pakistan
By Dr A. KHAN
Nov 29 - Dec 05, 2004
Health insurance scheme should be introduced to the country. In a state there are four elements i.e. state a geographical territory, population, government and sovereignty. God Almighty has created man in the best form. Man is the agent of causing major changes on the earth. We may call it an artificial change but most of the body part of the human being is controlled by the sympathetic nervous system i.e. are beyond the control of human will. Does it help in a way to understand the coherence of thought processes for analyzing and reaching a conclusion? In the state we are going to consider him physiological being only and will extend health insurance scheme for that part of him.
Government is people and population is people. Anything that is done in a territory of the state can be done for the benefit of the people inhabiting it. Government is to decide justified distribution of the resources among the people. Sovereignty is looking after the justified implementation of rules.
Health is a basic necessity and must be provided to every individual of the state, wherever and whatever he is. A healthy man contributes better to the productivity of the country. It, therefore, must be free or at a minimum cost. Infrastructure made for this basic need can prove of enormous benefit to the overall planning and administration of the country. To provide proper health services to the nation, we must have proper availability of data, of the resource, manpower, and its demographical placement. This knowledge is extremely valuable for the planning of the country for optimized resource deployment and calculated results of the efforts. By proper planning we can start the process of collection of human resource information and improving their health. Since this need comes after the provision of water and food, air being always freely provided, (by the God Almighty), without any effort on this earth.
WHAT IS THE HEALTH INSURANCE SCHEME?
1. Every person in the country should be benefited by the scheme, irrespective of being rich or poor. Health should be considered equally important as air and water.
2. There should be extensive out patients department for every 5000 patients
3. Each OPD must be linked to a district/subdivision headquarters hospital for required treatment or hospitalization, if needed
4. Each doctor should be given plot of 300 to 1000 yard depending upon locality and free by the government under Health Scheme.
5. A doctor should be given a annul remuneration of Rs. 200,000 to 500, 000 per annum gradually for himself, a ward boy and a nurse.
6. A loan of Rs. 20,00,000.00, two millions for the construction of OPD, recoverable over 25 years and with least interest, in quarterly or half yearly installments, it should be interest-free if possible.
7. A telephone and computer should be provided to keep the record of registered patients, attending patient and ailment and treatment as well as link with hospitals and patients.
8. Computer should be linked with a central database of the Group Life Insurance Company and OPD should transmit data regularly on hourly basis.
9. The linked hospital should be provided with all the facilities to attend most of the patients' needs and arrangement for respective transit of the patients to better facilitate hospital when needed.
a. Each individual should pay Rs. 1000/ per year. Family head should be responsible for payment of premium for every individual of the family.
b. If the family is poor the premium should be collected as donation for the poor family. This is from the rich part of the nation side. The entire nation should participate in the task. This is going to be genuine benevolent fund for the nation. '
c. Equal amount should be segregated from the federal government budget for the fund.
d. Government should endeavor to get grant for the same on international level. This will help in providing best possible medical facilities to the nation.
e. There should be regular addition to the fund every year. There is possibility of interest-free loans and grants for this scheme.
f. Possibility of lottery tickets properly arranged by a dedicated body may also generate funds.
HOW TO GET STARTED
Following bodies need to be created:
i. Fund Collection and Generation Body
ii. Site Selection Construction of OPD Body
iii. Hospital Construction and Rebuilding Body
iv. Data Collection and Integration Body
The above jobs can be assigned to a Group Life Insurance under the supervision of the government.
1. All the Health Ministries of the Provinces should unite to form a single Federal Ministry. Two of the above job b and c can be taken care of by the Ministry, along with generation of funds by grant, loan or charities. This, however, should be single Health Fund.
2. Ministry should select a site of 300 yards in busy urban areas and at least 1 to 2 acres in rural areas for the OPD's. This selection will be on the basis of 5000 patients only. In urban areas multiple OPD's can be grouped at one location.
3. Doctors appointed for these OPD's must be provided with telephones and computers to keep the records of the patients, medicines available and consumed, ailments of the patients, diagnoses and treatment given.
4. The computer should be a part of the centralized computer system with health insurance number as the identification key to be used everywhere. So that transit of each patient to next stage must be clearly visible for next treatment and care.
5. Health Insurance Number must be unique through out the country. This is extremely essential for the health of the patient as well as for the country. This number can be used for many planning purposes for the government. Since it provides the idea of the human resource of the country, their geographical placement, health, causes of death, education, tax status, ID Cards, Passports. It can provide a comprehensive look of the life of an individual, his successes, failures and achievements in life. Rate of mortality and growth can be seen for geographical units and resources can be justifiably diverted for the improvement of the respective area or areas.
6. The data can be shared and enhanced as required by the other ministries. A concept of block budget for the country can be used to enhance the progress of the country with comprehensive central control to avoid pilfering, leakage or misuse.
7. A body for collection, integration and information about the where about of the patient, status of health, diagnosis, prescription should be started immediately to set their respective program/software with the first opening of the OPD.
SPLIT INTO MULTIPLE PROJECTS
Six months should be given for fund collection after issuing the proper order for implementing the scheme. In this time software should be ready. After six months planning for the respective dispensaries should begin. The process can be started simultaneously for as many location as the funds permit and should be completed for the entire country with in two years. There are multiple projects like Software development, Selection of Site, Selection of Doctors and staff etc.
Most of the tasks can be initiated in parallel and can be completed in the first year. From second year onward will be implementation stage. Since it is repetition of standard work, it can be supervised and controlled as a multi-project. The next two years will consolidate the task and will help to guide and enhance the planning part of the country. Many tasks will streamline the country's economy, tax structure, land calculations, water assessment, power generation, distribution and waste, idea of production, expenses and resources of the country. We will discuss the individual topic one by one to have more clear concept of the implementation.
DEPARTMENT OF INTERNAL AFFAIRS, ID CARDS AND PASSPORT
Department of Internal Affair can make use of the data by enhance the data further to add requisite fields or create new relations with National Health Insurance Number as indexing key. The basic data will be available; adding more requisite data field as separate entities, will make it very useful for this department. It can be used for Identity Cards and Passports. The data base can be programmed to intimate, rather, prepare Identity Cards for those persons who will be acquiring specified age in a month time for issuing the identity cards. The ID Cards can be issued with congratulations by the Head of the State on their birth day and acquiring the age of maturity and responsibility to serve the nation. This can be a regular job and burden for issuing ID Cards and passport can be minimized as no application will required to be filled or any other hassle.
If the department does its job with due planning, it perform its functioning without wasting effort in unproductive pursuits. The departments will have the idea of the population. Data can be arranged to get the information about rate of growth and mortality, per capita income, GDP etc.
The department can be planned to execute such jobs as the employment, education of the people, their location and their placement closer to their residence.
DEPARTMENT OF PLANNING
The department of planning will have the following information available with little effort. Geographical placement of human resources, availability of facilities to these resources, like education, roads, bridges, means of communications, the products of the areas and means for distributions etc. the information will be available for each square miles of the country and the present status. So it will be easy to suggest a development plan for areas where it is really necessary. The prepared proposal will have comprehensive data to substantiate the suggested plans. They can further match it with the budget and suggest a priority level for the benefit to the country and the people.
With little more research and study, it is possible to come up with the suggestions which are consistent with the environment, skill level, agricultural produce and suggesting ways to add value to the products by small mechanical means.
The department can further assess the result of its efforts and find exact figure for its contribution to the national progress. They can have foresight to the development of all the areas with a justifiable sequence. Audit check and control will be part and parcel of the honestly implemented system. The planning can be made for ten, twenty even more years and change of people will not affect the progress of the country.
DEPARTMENT OF INCOME TAX
Income Tax department can ensure realistic assessment of the taxable products and persons. It is possible to link tax with the produce of the country, which should result in more harmonious environment for both Tax Department and Tax payers. With this availability of data there is every possibility that the genuine tax will be recovered from a large base of tax and will encourage government to lower tax rate. The tax slabs can be enhanced with calculated and sure results, with little efforts, of course.
DEPARTMENT OF INFORMATION TECHNOLOGY & DATA INTEGRATION
Department of information technology should focus on integrating the data and facilitate requisite addition of data for every department. The department should further work to provide facilities to capture other information about the country and foreign affairs. It can also provide work group facilities to the group whose members are quite away from each other, distance wise but can join hands with their expertise for a particular task i.e. geographical distances can be eliminated for collaboration of expertise. Another role of the department should be to update every department about the constantly adding facilities and how they are useful for various departments.
DEPARTMENT OF DEFENCE
The department of defence is very important for a country. The data collected so far can be comfortably used with further addition of the requisite fields can be segregated into forces among Army, Navy and Air Force. A comprehensive knowledge about each force can be developed. This will be very useful for the Head of the State to know his country's strength and weakness. The department should further add information about other countries of the world to make a comparison and need for development in a specified field. The information can be made protective from rest of the unrelated people and world. But the exact knowledge will help in the development and acquisition of resources in genuinely needed lacking field so that the country should be empowered to face the biggest enemy in time of need with well directed efforts.
DEPARTMENT OF LAND AND REVENUE
Department of Land and revenue can have clear idea of the land, ownership of the land, agricultural land, residential land, their occupant, and revenue that is generated through levying taxes. The department can have the idea of canal, rivers and their outlets for drinking and agricultural purposes. Water wasted in the sea can also be calculated. The storage of water can be planned to avoid wastage. The sources of sweet under ground water can be identified. The sweet water can be added to the canals or rivers for agricultural use. Saline water can be treated to make it softer and useful. Cost and benefits of the effort can be evaluated for preparation of feasibilities and their implementation. The relevant information can be made available on the web site of department for benefits of the public use. Independent of the government efforts of the individuals will increase the productivity. The effort of the department, even if provided free to the public will help generate taxes and more revenue for the country as a reward of research of the department.
DEPARTMENT OF WATER, POWER, PETROLEUM AND GAS
As discussed under the department of Land and Revenue, the national health insurance data can be enhanced by the department to generate another aspect of the knowledge and information about the country. Yet another use with further extension of data is for water, power, petroleum and gas. It is possible to evaluate the residential use of power. The generation of power can also be evaluated. The distribution of bills can give the exact figure as to how much power, water, gas, is generated, billed and wasted. If the wastage is more than genuinely expected limits, it can be verified and corrected. This will result in proper evaluation of the cost and consequently cheaper power to the consumers. Rise in prices can be controlled and wastage is minimized because of the knowledge of the geographical placement of the human resources, power generating units can be dispersed more close to the needed location to avoid losses and make it cheaper to be used both for home and industry. A single utility bill will be possible, if needed. However, a report about individual bills can be comfortably compiled.
DEPARTMENT OF TRADE AND COMMERCE
The data can be made useful for the trade and commerce. By exactly knowing the location of the produce to be supplied, trade can be initiated from the nearest location for shipment to the destination of demand. It is possible to calculate the demand for a particular geographical location for certain products of a specified area. So it can be supplied to the desired location directly instead of transporting it to multiple locations, which results in heavy cost and deteriorated product. Trade and Commerce department should not only be aware of the product of the country and its utility with in the country but should also collect information about other countries which will be in demand for their products, The information researched and synthesized on a web site for public use may result in much better and progressive economy. The faster means for information and transportation can lead to lesser turn over period, this will enhance the utility of money with better rate of return. Each department is working symbiotically for the progress of the country, time, situation, means of transportation, timely supply of the demanded commodities will raise the progress graph in a very encouraging way.
DEPARTMENT OF INDUSTRY
Industry plays a very important role in a country. Some of the industry is essential to add value to the raw material of the country, The raw material of the county may be agricultural produce, minerals, adding value to raw material of some other country, intellectual or high tech products. Each part is essential for uniform development and to be at par with the developed countries. The data can help evaluate the existing industrial, market of the country as well as international market. The size of the industry can be planned accordingly. If there is need for man power export some of the industry may not contribute much to the economy of the country directly but can be a way for developing manpower for export. The quality of this manpower must meet the international standards. This, sometimes, may become a good source of foreign exchange income. So all sort of industries must be carefully planned. The National Health Insurance data can be used for development of man power and market research. This can further assist in predicting the performance of an industry in the country.
DEPARTMENT OF EDUCATION
The data collected for health insurance has the capacity to be used for evaluating the education level of the country. Geographical position of the schools, colleges, universities and their curricula with variations can be extracted with requisite entity addition to the database, Information technology is so well developed now that it is possible to have uniform curricula for urban and remote areas.
The way of learning and teaching have been developed to such an extent that traditional method of learning are exceedingly slow process in their comparison. New techniques should be used to enhance learning process. There should be constant improvement in the curricula to be at par with latest requirement of the education. The curricula of the university should be made according to latest trend in teaching. If they see the courses of the developed countries, they will be amazed at how far behind they are even from the weakest of the foreign universities. If we keep on imparting such type of knowledge, and that even in traditional ways; there is little chance of improvement. The data for the human resource will be available by making use of the latest techniques, it is possible to develop faster and geographically uniformly educated and skilled manpower. Initially, we might have to copy what is available but must keep it in mind to develop our own means to such an extent that the outer world feels our genuine contribution to knowledge. Our way of learning and teaching should be inspirational for the rest of the world. Teaching faculty is also a field for trained manpower exports. Today education is knowledge plus skill. The concept of the National Health insurance data provides enough means to impart knowledge and skill to the students where ever they are, only the course material has to be designed this way. Since it is interactive way of learning, the time for learning and acquiring skill can be reduced substantially.
DEPARTMENT OF SCIENCE AND TECHNOLOGY
The science and technology is backbone for the development of a country in the present era. The data about human resource, their education and performance will be available. It is matter of selecting right people for the job. At the same time it is imperative to select the right projects/topics for research. Technology should be developed for the country in which country really can excel in the rest of the world. Presently research must be started from the best possible practices and making improvement in them so that we can come up with superior products. Embedded systems are getting fast response and have better marketability. If our research is initially for better economic prospects, in the way we are bound to come across thought processes to know the real laws behind some happening. It was Newton, who observed the phenomena of falling of an apple on his head and thought out about the gravitational force. The force, of course, existed prior to his existence. There is still lot to learn and explore. Internet provides information about every conceivable thing by human being. It is for us to collect and relate things to reach some innovative results
DEPARTMENT OF FINANCE
The data for the human resource of the country can be made transaction based both human and department wise. This will help us to identify opportunities, resources, performance and development of our country. The concept can make the entire process of income and expense highly transparent and each individual answerable to each other. This will be country for the entire nation. Each individual contributing to the progress of the country and seeing his performance recorded. Transaction based economy might result in freedom from expenses on many departments, still it will be more human and mature society. All sorts of ratios about the performance of the individual department and their collective effect can be derived. We can be sure of the operational expenses with a fair chance of comparison and results. This will further help us identifying more lucrative ways to develop productive procedures. It will also be possible to get information about the performance of any individual of the country with complete accuracy.
DEPARTMENT OF FOREIGN AFFAIRS
The data about the country will be extensively available, through the above procedures. The infrastructure will be laid for getting information about other countries It needs to segregate the relevant information about other countries This is further possible to compile and arrange information about other countries in a systematic manner to derive conclusion for their relationships, trade, commerce and friendship.
Other departments like Administration, General Services, Law, etc. can also be integrated in a similar fashion. A main central department should control all the other departments. This department should have data and information about all the departments. The information should be made available to the Chief Executive or Head of the State for Just decision making. He should also be provided complete simulation about the pros and cons of the decision before formalized orders.
COST OF THE PROPOSAL
The cost of the proposal for health insurance is Rs. 1000/per person for the country. The equipment can be leased; the premises can be hired initially for OPD. Only 0.1% will be the cost of software development for the initial set up. Funds can be generated by the procedures suggested under para 2. Once started, the cost of software/hardware will be recovered shortly through the benefits and streamlining of the procedures. There will, otherwise, will be lot of saving in terms of time and money with fruitful and straight forward decisions. The enhanced productivity due to less time required for preparation of meeting due to the help of instantly available data.
The total cost of the project for the entire country with comprehensive change in all the departments will be within the budgets of all the departments. It will be matter of streamlining the procedures and getting trained to make use of the available data to generate useful information. Some cost might have to be spent on information technology department for integration of data from different departments. It of course will be nominal comparing to the benefit it will render in return. So total cost will only be the sincere implementation for the cause of nation. Do just one good thing for the entire nation and rest of the good things for the nation will be it's by product.
Pakistan will be a completely different economy in next ten years. With honest dedication, our country can be placed in the developed countries line in this period.
Head of the State will have all the information about the country on his desk top all the time. With in a few years, Chief Executive of Pakistan will be most informed person about his own country.