What political parties believe about healthcare
With Pakistan’s total expenditure on healthcare amassing to a mere 3 percent of its GDP, an infant mortality rate of about 9 percent (the 11th highest rate in the world according to the World Bank), and a general lack of efficient and operational healthcare delivery systems, it is pertinent to discuss what each major party promises to do for healthcare if it is elected. While the Pakistan People’s Party (PPP) and Awami Workers Party (AWP) have focused primarily on mechanisms to increase the equitable distribution of healthcare services, the Pakistan Muslim League-Nawaz (PML-N) focuses on enhancing existing healthcare facilities. The Muttahida Qaumi Movement (MQM), on the other hand, focuses more on creating more institutions to address the various health concerns that the current system ignores, much like the Pakistan Tehreek-i-Insaf (PTI) which aims to use its Sehat Insaf Card to provide large-scale and broad healthcare provision throughout the country. But how realistic, viable, and comprehensive are their plans?
While there is no denying that the PML-N has improved healthcare facilities during its tenure, one of the foremost criticisms it has received has been in response to its asymmetric focus on developing Northern Punjab; the very fact that there is an increasing demand for a separate province in South Punjab is indicative of the discontent the population has about the PMLN’s development policies. The phrasing of their manifesto does not allay these fears, since it is dedicated almost entirely to strengthening existing institutions through funding research and providing quality equipment.
In comparison, the PTI has proposed focusing on expanding the healthcare provision net, aiming to cover previously neglected health concerns and develop an integrated and holistic healthcare provision network. If they are to go through with their plan, perhaps the most prominent fear that the PTI’s healthcare policy will prompt is its lack of focus on ensuring the deliverance of quality healthcare. Even though creating facilities and institutions to address health concerns such as mental health is essential to Pakistan, previous administrations have shown that there is often a lack of efficient, quality care to accompany such institutions.
In similar vein is the recently-wounded MQM which, to the PTI’s credit, presents a plan that is nowhere near as detailed as that of its counterpart. The MQM’s manifesto is incredibly vague, alluding briefly to issues that are essential for the country and proposing uninspired and generic solutions to complex problems. The MQM does, however, promise to increase expenditure on healthcare to 5 percent of the GDP and ensure the effective use of finances. How it plans on doing so, however, remains a looming question.
A different approach is that of the AWP and the PPP which have, in their capacities as more left-leaning political parties, focused primarily on the equitable distribution of healthcare resources throughout the country. With the PPP’s integrated healthcare system to establish a cohesive system for healthcare provision across the family, and the AWP’s promise to regulate prices at autonomous/private hospitals, both parties have promised to eliminate the asymmetry of experiences in Pakistan’s health sector.
The PPP, at least on paper, presents a plan that grapples with the lack of healthcare provision services across the board with a particular focus on maternal and child care. While they propose cash incentive programs to incentivise the use of healthcare in the early development of children and also promise to broaden the scale of free healthcare provision across the country, the question for the PPP remains the same: will it be able to eliminate the remnants of its corrupt past and judiciously use public money for healthcare provision, or is its fresh outlook merely a facade?
The AWP aims to address the concerns of those who cannot afford high-quality healthcare with promises to ensure that price exploitation by pharmaceutical companies is curtailed and aims to provide health workers with permanent employment. There are, however, two major questions that the AWP’s plan prompts: first, will the AWP, a party that does not have any hopes of a majority in the government or the opposition bench, be able to grapple with the powerful capitalist monopolies that private hospitals and pharmaceutical companies command? Second, given that the AWP is very new to politics in Pakistan, will it be able to stay true to its promises in a divided parliamentary democracy?
All in all, each prominent party presents a different approach to addressing the perennial issue of quality healthcare in Pakistan; while some propose broadening provision, others focus on strengthening existing systems. Each plan in itself is a potentially viable solution to Pakistan’s healthcare problems and differentiating between the viability of each plan may be a purely polemic task, but if precedent is to be followed, what will perhaps differentiate one party from another is the degree of trust the public has in its ability to deliver.