Aasandha MD Highlights Co-payment as Key to Ensuring Sustainable Health Insurance

In a parliamentary hearing, Aasandha’s managing director, Zeeniya, stated that to ensure Aasandha’s sustainability, transitioning to a co-payment system needs to be considered. She expressed support for the idea of individuals contributing to the insurance service.

This statement does not indicate a current change in the company’s policy.

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Ibrahim Rasheed queried the absence of the service being categorised as an insurance system, expressing concerns about the escalating costs associated with Aasandha.

Responding to the query, Fathimath Zeeniya, the new Managing Director of Aasandha, clarified that the company needs more authority to modify the Aasandha scheme independently. She highlighted that Aasandha operates based on a scheme mandated by the National Social Protection Agency (NSPA).

Zeeniya expressed support for transitioning Aasandha into a service that includes a co-payment or an annual fee from the public, emphasising that changes to the scheme would require direction from the NSPA.

Addressing factors contributing to rising costs, Zeeniya identified the unregulated accessibility of Aasandha services from pharmacies and healthcare providers. She mentioned clinics seeking Aasandha accreditation before opening and private healthcare facilities receiving funding from Aasandha.

Zeeniya also highlighted the challenge of high treatment costs in some local hospitals and clinics, surpassing expenses for overseas medical care. Initiatives, such as creating packages for health centres, are being pursued to control Aasandha costs.

In addressing the escalating expenses related to overseas medical treatments, the government contemplates grading hospitals and imposing limits or co-payments on services.

Zeeniya provided insights into Aasandha’s cost breakdown, indicating that 56% is allocated for medications. Measures have been implemented, including a code-based system for medication retrieval to prevent fraudulent practices. Efforts to restrict the repetitive use of a single prescription before its expiration and bulk procurement of 11 expensive drugs are underway to mitigate costs.

Zeeniya concluded by emphasising the importance of keeping the number of pharmacies selling Aasandha-covered medicines within a specified limit as part of ongoing measures to enhance cost-effectiveness.

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