According to a statement released by the Aasandha Company on Sunday, private clinics are being included in the scheme after they agreed to a revised price list for health services with the National Social Protection Agency (NSPA).

The scheme will cover the treatments from those private clinics based on the revised price list, while the clinics are allowed to charge their patients to cover any additional costs.

“Therefore, patients will likely have to share the costs of outpatient care and other services,” the company adds.

The authorities have not revealed the amount to be charged, but State Health Minister and National Social Protection Agency (NSPA) Board Chairman Thorig Ali Luthfee told local media that the “charge will not be a burden to the patients.”

“In addition to what is being (covered) from Aasandha, they might charge a small amount from the patient. Once they agree to the price with us, they cannot alter that price,” Thorig told Haveeru.

According to Thorig, four clinics have so far agreed to the prices, and Aasandha services will be offered at the clinics as soon as the agreements are signed.

Price negotiations with several other clinics are still reportedly pending as over 60 private healthcare providers have applied for Aasandha coverage.

According to the Aasandha website, the scheme currently covers treatment from IGMH, ADK Hospital, IMDC Hospital in Addu and other hospitals and health centres currently operated by state-owned health corporations.

Thoriq observed that privately-owned ADK, the second largest healthcare provider in the country, will also have to confirm the revised prices agreed with NSPA to keep providing Aasandha services from next month on wards.

Under the parliament-approved scheme which commenced in January, all Maldivian citizens will receive government-sponsored coverage up to Rf100,000 (US$6,500) per year, including further provisions to citizens who require further financial assistance. Expatriate workers are also eligible for coverage providing their employers pay an upfront fee of Rf1,000 (US$65).

MDP’s critical response

Following the decision to charge patients at private health premises, the former ruling Maldivian Democratic Party (MDP) which initiated the universal insurance scheme, under its affordable healthcare pledge, contended that the government’s decision reflects attempts to “restore the tradition of begging to afford health care services”.

According to the statement released by the MDP, the agreement signed between Aasandha company and the government explicitly states that no amount can be charged from the patients.

“The agreement signed by the Finance Ministry, Health Ministry and Aasandha Company explicitly states that no amount should be taken in fees or as any other charge from the people,” the statement reads. “Therefore, we condemn the coup government’s attempts to charge people a fee for healthcare services.”

The party also accused the government aligned Progressive Party of the Maldives (PPM) and coalition alliance of deliberately attempting to sabotage the health insurance scheme.

The MDP noted that while the party was in power it had regularly made the payments to Aasandha company as per the agreement, however, the incoming government of President Dr Mohamed Waheed Hassan Manik had not made the payments, pushing the scheme to the brink of collapse.

Aasandha is a public-private partnership with Allied Insurance. Under the agreement, Allied splits the scheme 60-40 with the government. The actual insurance premium is paid by the government, while claims, billing and public awareness is handled by the private partner.

Aasandha Managing Director Mohamed Shafaz told Minivan News last week that the government had failed to cover weekly premium payments as agreed under the Aasandha contract since March 2012.

He alleged that while the scheme was continuing to run, the shortfall in state funding was creating some difficulties for service providers such as hospitals and pharmacies both in the Maldives and outside the country in the wider South Asia region.

Without detailing specifics, State Health Minister Luthfee said that the government was presently involved in consultations to clear outstanding bills. He added that a target of 30 days had been set to try and settle outstanding debts to creditors.