Peshawar, September 25, 2025 – A major healthcare crisis is looming in Khyber Pakhtunkhwa as the Peshawar Institute of Cardiology (PIC), one of the province’s leading cardiac facilities, has indicated it may suspend treatments under the government’s flagship Sehat Card program starting October 1. The warning comes amid mounting financial disputes with State Life Insurance, the implementing partner of the scheme, and unresolved dues that run into billions of rupees.
According to an official letter sent by the PIC administration to State Life Insurance, the hospital has not received payments worth nearly Rs. 1.5 billion for treatments already provided under the Sehat Card. The non-payment, the letter states, has severely affected the hospital’s operations, disrupting the procurement of essential medicines and medical supplies. If the dues remain unsettled, the institute has warned it will be left with no option but to withdraw from the program, halting treatment for thousands of patients who rely on the Sehat Card for free or subsidized healthcare.
The Sehat Card Plus program, introduced in Khyber Pakhtunkhwa and later expanded to other provinces, was hailed as a revolutionary step toward universal healthcare coverage in Pakistan. Under the initiative, families could access medical treatment at both public and private hospitals without direct out-of-pocket expenses. However, the program has faced persistent financial hurdles in recent months, with hospitals repeatedly complaining of delayed reimbursements and unsustainable operating costs.
Adding to the crisis, provincial health department officials confirmed that the Khyber Pakhtunkhwa government itself has yet to release around Rs. 12 billion to State Life Insurance, the insurer tasked with managing and disbursing payments to hospitals. This cash flow bottleneck has cascaded down the system, leaving hospitals like PIC struggling to manage patient loads without adequate funding.
A senior official at the provincial health department, speaking on condition of anonymity, acknowledged the financial strain, stating:
“The government is facing serious fiscal challenges, and this has affected the timely release of funds for the Sehat Card program. We are trying to make partial payments, but the gap is large, and hospitals are understandably frustrated.”
For PIC, the financial crunch could not come at a worse time. As one of the few specialized cardiac hospitals in the region, it serves not only patients from Khyber Pakhtunkhwa but also referrals from across northern Pakistan and even neighboring Afghanistan. The suspension of Sehat Card services would disproportionately affect low-income patients who depend on the program for life-saving cardiac procedures, such as bypass surgeries, angioplasties, and pediatric heart operations.
Doctors at the facility warn that if the impasse continues, patient care could be jeopardized. “Cardiac patients cannot wait indefinitely for treatment,” one consultant cardiologist explained. “Delays in procedures like angioplasty or bypass surgery can mean the difference between life and death. Without Sehat Card coverage, many patients simply won’t be able to afford treatment.”
The looming suspension also raises broader questions about the sustainability of the Sehat Card scheme. Experts argue that while the program was politically popular and significantly expanded healthcare access, it was launched without robust financial planning. Hospitals have frequently complained about underpricing of procedures, delayed reimbursements, and bureaucratic hurdles in claim settlements.
Critics say the program’s financial woes highlight a deeper structural issue: the overreliance on a single insurer (State Life) without adequate checks and balances. In the case of PIC, the non-payment of Rs. 1.5 billion has not only affected service delivery but also cast doubt on the feasibility of a new contract with State Life, which the hospital administration has described as “not viable under current circumstances.”
On the other hand, supporters of the program argue that despite its challenges, the Sehat Card remains a vital tool for reducing health inequities in Pakistan. “It’s one of the few initiatives that has actually given poor families access to tertiary care,” said a health policy analyst. “The real issue is mismanagement and lack of fiscal discipline. Instead of scrapping or weakening the program, the government should fix its funding model.”
For now, the provincial government has assured that it is “making every effort” to clear outstanding payments and sustain the Sehat Card scheme. However, with the October 1 deadline approaching, uncertainty remains. If PIC follows through on its threat, it could set a precedent for other hospitals to withdraw as well, triggering a broader collapse of the program in Khyber Pakhtunkhwa.
The situation places immense pressure on both the provincial administration and State Life Insurance to find a quick resolution. For thousands of heart patients across the province, the stakes could not be higher.
