Nepal, China discuss strengthening health insurance cooperation

KATHMANDU, APRIL 22: A high-level discussion on health insurance was held yesterday in Chengdu, Sichuan Province, between the Nepal Insurance Authority and the Sichuan Health Security Administration under China’s Sichuan Provincial Government.

The Nepali delegation was led by Sharad Oja, Chairperson of the Nepal Insurance Authority, while the Chinese delegation was headed by Zhang Hefeng, Deputy Director General of the Sichuan Health Security Administration. The meeting covered a wide range of topics, including health insurance systems, policies and structures, and health security.

Discussions focused on strategies to ensure the sustainability of health insurance, reforms in payment systems, coverage and protection offered by insurance, private sector-led health insurance schemes, methods to enhance accessibility and affordability of services, public-private collaboration in health security, transparency in service delivery, building public trust in insurance, and enhancing efficiency through digital technology.

Deputy Director General Zhang Hefeng provided an overview of Sichuan’s health security system, which is structured in three tiers: basic healthcare services, critical illness coverage through premium contributions, and medical assistance programs.

He further explained that the benefits provided to citizens are adjusted based on the financial capacity of the institution. Citizens are encouraged to purchase health insurance for treatment of diseases not covered under the government’s health protection plan. Under this plan, essential medicines and basic medical services are provided regularly.

Zhang also highlighted efforts to curb fraudulent claims by strengthening internal controls. Strict penalties and legal actions are imposed on healthcare institutions found guilty of making false claims.

He added that the scope of services under the government’s health protection program is expanded based on the institution’s financial capacity and state subsidies. He noted that private insurance companies offer a wide range of benefits through their health insurance products.

During the discussion, Chairperson Sharad Oja raised questions regarding the differences between public and private health insurance schemes and the sustainability of public health protection systems. He stated that the Nepal Insurance Authority would incorporate the learnings from Sichuan’s experience while formulating health insurance policies in Nepal.

From Nepal, participants included Chairperson Sharad Oja and Executive Director Sushil Dev Subedi of the Nepal Insurance Authority, along with Nepal’s Consul General in Chengdu, Suresh Raut.

From the Chinese side, participants included Deputy Director General Zhang Hefeng; Li Yazhun, Head of the Planning, Finance, and Regulation Division; Li Rui, Head of the Benefits and Security Division; Wang Yiguo, Head of the Medical and Pharmaceutical Services Management Division; Liu Zhengkui, Head of the Operational Guidance Division; and Xiong Wengweng, Deputy Head of the Medical and Pharmaceutical Pricing and Bidding Procurement Division.