National Health Insurance Authority on a path to overcome difficulties

Since 2006 when the NHIS was established to replace the cash and carry system, many Ghanaians young and old have been admitted onto the scheme and are benefiting from health care throughout the country. However of late the scheme come under pressure from service providers made up hospitals, clinics and pharmacies who were demanding monies the scheme owed them in recent past.

The indebtedness of the scheme to the service providers got to the point where some of the service providers threatened to stop providing medical care to holders of the NHIS cards a situation that would have taken us back to the difficult period before the establishment of the scheme. Fortunately the government has come to the aid of the scheme by dolling our huge amount of money to the service providers concerned.

My random visits to some medical centers in Accra and telecommunication with some people in other parts of the country has shown that most of the service providers did not stop treating NHIS card holders before the payment was made and up till now they continue treating subscribers of national health insurance scheme. It is the desire of all well meaning citizens of Ghana that all service providers would be compassionate to continue to give medical care of all those who call at their clinics, hospitals and pharmacies across the country. Most of the subscribers are poor and cannot afford to pay huge medical bills. A study of the situation has shown that the scheme run into difficulties owing to raid increase in the number of subscribers and the high cost of caring for them while their premiums are negligible.

Although the government provides amounts from value added tax to supplement the premiums the amounts are still not enough to pay the service providers resulting in the government dipping its hands in the nation’s coffers to bail out the NHIS over its indebtedness. The situation calls for a dialogue between the service providers, the Ministry Of Health, and the NHIS to find ways of dealing with the situation.

Fortunately the NHIS under the leadership of Mr. Silvester Mensah has began the process of rolling out the capitations grant and other measures to cut down on the cost of medical care under the medical insurance scheme in Ghana. The capitation grant which began in the Ashanti region is being extended to the Volta, Upper East and West Regions to be extended to all parts of Ghana later.

Under the scheme each subscriber of the scheme will be made to register under one service provider of his or her choice where they will expected to receive treatment at all time at an approved cost. This method will make it possible for the NHIS to know the cost of medical care of members of the scheme in advance to help in their budgeting and financial expenditure. This is a step in the right direction that must be supported by all.

Another method meant to find solution to the problem of high cost of medical care under the scheme is the introduction of the biometric registration of members of the scheme to capture the biometric and physical features of the members. This is l meant to eliminate fraudulent use of the cards by non members of the scheme. According to some workers of the NHIA this method would lead to only members of the scheme using the cards issued to them. One other issue that needs to be addressed is the nonpayment of premiums by children below the age of 18 and whose number is growing rapidly.

There is the need to revisit this policy under the scheme to allow those children whose parents can afford to pay the premium to do so. While commending the service providers for rescinding their threat to withdraw their services to subscribers of the scheme, I suggest that the leadership of the NHIS would continue engaging them in discussions. The chief executive officer and members of staff of NHIA should continue to maintain their calm as they have done so far as they pursue the cause of bringing improvement to the scheme. This way the increasing members of the scheme will continue receiving medical care while the service providers receive their payments on time to be able to remain in business

Executive director

0244 370345/ 0264370345/0208844791 [email protected]/[email protected]

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