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Difference Maker

In Pakistan, Asher Hasan brings innovation to health-care cost, at $1.80 per month

Pakistan's low-income families can buy inexpensive health-care insurance through his Nava Jeevan (New Life) program.

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Last year, the Pakistani government spent an average of $18 per person for health care, one of the consequences of its struggle to deal with an ongoing battle against Islamist insurgents on its western border and the aftermath of last year's catastrophic floods.

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Across the developing world, catastrophic illnesses can wreak havoc on families, who may be forced to sell their most valuable possessions or pull their children out of school to pay medical bills.

Hasan has first-hand experience. Born in London into a middle-class family, his mother moved him and his three sisters to Karachi following the death of their father in 1983. On a trip back to Britain, Hasan's mother suffered a nervous breakdown. She had no contact with her children for the next three years.

During this time, Hasan grew close to the children of his maid. While his education was provided for by the colleagues and friends of his late father, his maid was unable to tap any wealthy connections when her father fell seriously ill, forcing her to withdraw her children from school.

"I realized that a single catastrophic event can lead to the perpetuation of the cycle of poverty," he says. "We had to create a system which could break that cycle."

Pakistan's failure to bridge its rich-poor divide is a source of class resentment that some say plays into the hands of the country's extremists, including the Taliban. The killing in January of liberal politician Salman Taseer exposed the fault lines, as the wealthy English-speaking classes took to the streets to protest his death. Pakistan has not done enough to bring about "economic democracy," critics say – thus generating recruits for Islamist extremists.

The Naya Jeevan program isn't perfect. Outpatient care is not provided, pre-­existing conditions are covered only in certain cases, and the upper limit of $1,800 per year means patients may not be able to afford follow-up care after an expensive hospital stay, says Bokhari, the health economist.

"Incidentally, this was also a shortcoming of the early days of Medicare hospital coverage plans in the US," he adds.

Naya Jeevan has paid for such extra costs through donations. But Hasan hopes to expand the scope of the insurance plan over time. The program will reach a fiscal break-even point when 75,000 people are signed up, Hasan explains, almost six times the number of current participants.

The next step after that, he says, will be to work with other major institutions to sign up 2.5 million Pakistanis and lobby the federal government to set up a similar program of private health-care insurance nationwide.

• Naya Jeevan is at nayajeevan@njfk.org

• For more stories about people making a difference, go here. 

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