Pakistan’s government has launched a national health insurance program for its poorest households - marking the start of the most-ambitious public health project in the country’s history. The Prime Minister’s National Health Program will cover families that make less than $2 a day through a gradual rollout. In the first phase, over 3 million families will get health insurance in 23 districts, with the ultimate aim to cover 22 million households across the country.

The State Minister for Health Saira Afzal Tarar has announced the issuance of health cards to enable the underprivileged to receive treatment at private and public hospitals free of charge. Private hospitals that sign up will then be offered loans on easy terms to upgrade their facilities. Moreover, the national health program, with an initial funding of 9 billion Pakistani rupees ($86 million) will pay for the treatment of critical illnesses and infection.

The design of this program is extremely praiseworthy, one that is ensuring that adequate health care is provided to the poorest citizens of the country. However, given that our 2008 estimates tell us that over 60% of the population lives on the $2 poverty line, its implementation remains challenging and far from likely. Do we even have resources to cater to more than half of our population? Between July 2014 and March 2015, Pakistan spent just 0.42% of its GDP on health- a figure that shout out loud and clear the dismal state of our health sector.

Pakistan’s low health spending and inadequate management are key factors in the poor health provision, where the government, even with subsidies, is unable to handle the patient load or achieve public health targets. Additionally, does this program entail that all private hospitals will be open to the poor? Another big question regarding the success of this health program would be regarding the transparency in it. This news-story doesn’t tell us what are the limitations in the card, and even if it is a good program, opposition parties will make sure that it becomes a casualty to political ambitions.

We need to start from the basics- getting public hospitals at least at every tehsil level with doctors and adequate equipment. Basic treatments should be available at all rural health centers. If basic facilities are not available, people cannot get healthcare, even if the government insures them. On paper the plan looks good. We are in desperate need of such programs for social welfare to help push the lower classes out of their poverty trap- if the deep pockets of managers, contractors and officials don’t eat up these billions of rupees meant for the masses.