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The federal government of Pakistan has presented a deficit budget of Rs18,887 billion for the fiscal year 2024-25. Alongside ambitious set targets which will be challenging to achieve, the budget brings positive developments for the journalist community in the shape of health insurance policy.

Journalists undeniably play a vital role in keeping the public informed and holding authorities accountable. Their health is crucial for maintaining a free and informed society. They often encounter unique occupational hazards while covering conflict zones or during pandemics. Offering health insurance to journalists will allow them to report without undue health concerns. This insurance will also enhance their job security, which can lead to higher quality journalism as they feel more supported and protected.

But allocating government-funded health insurance exclusively to journalists, while excluding the poor, is a contentious policy choice. It prompts scrutiny of the eligibility criteria and their alignment with ethical standards of justice and equality. The general public may view this policy as inequitable, potentially leading to social unrest or reduced trust in the government. This issue is especially acute in areas with significant health disparities. It is worth mentioning here that despite its growing urbanization, Pakistan struggles to provide adequate healthcare to its larger cities. Government policies often neglect the unique needs of urban populations, leading to a lack of infrastructure, resources, and services. This results in overcrowded hospitals and clinics, inadequate staffing, and limited access to essential medical care for city residents. The focus on rural healthcare, while important, overlooks the pressing demands of urban areas, exacerbating health disparities and affecting millions in major cities like Karachi and Lahore

The decision, therefore, appears politically driven, possibly to gain favorable media attention or avoid criticism, which could undermine the perceived legitimacy of the policy. While there are numerous professions that entail risks and hazards comparable to or greater than journalism, many of these professions do not have specific insurance policies tailored to their needs. The apparent reason behind this discrepancy appears to be the prioritization of gaining favour from journalists.

Excluding the poor population from health insurance support can exacerbate existing social and economic inequities. Since the poor often have greater healthcare needs and fewer resources, their exclusion is particularly harmful. Prioritizing journalists over the poor may overlook opportunities to enhance public health on a wider scale. Expanding health insurance access could lower general healthcare costs and improve societal health outcomes. Directing funds primarily to journalists might reduce the resources available for broader public health initiatives, thereby worsening existing inequities and restricting healthcare access for other vulnerable populations.

Some may contend that dedicating resources to a relatively small group, who might already have some level of employer-based coverage, is an inefficient use of public funds that could yield greater benefits if applied to the broader population. This approach also risks perceptions or instances of corruption, as the policy might appear to favour a specific group for political reasons rather than being based on objective needs. According to the budget plan, 5,000 journalists will receive insurance in the initial phase, with the remaining 10,000 to follow in subsequent phases. This reveals another policy flaw; it is likely that preference will be given to government supporters rather than to critics.

To ensure equitable healthcare delivery, the government needs to implement positive measures which include developing a more inclusive health insurance policy that covers vulnerable populations, including the poor, while also addressing the unique needs of journalists. This approach can help balance equity and occupational safety. They should establish a transparent and objective criterion for allocating health insurance as it is essential to foster public trust and ensure equitable distribution of resources. The concerned authorities should consider a tiered approach where different groups receive varying levels of support based on their specific needs and risks. This could include basic coverage for all and additional support for high-risk professions.

The Author is Dean Faculty of Dentistry, Baqai Medical University