Health Insurance Authority urges review of Scheme

Mr Anthony Gingong, Director of Payment at the National Health Insurance Authority has called for a stakeholders’ review of the National Health Insurance Scheme (NHIS) and the health care system as a whole to ensure effective service delivery in the country.

He said there was the need for government to prioritize the health care system because the strength and development of a nation was dependent on the health of its citizens.

Mr Gingong made the call on Thursday in Accra in an interview with the Ghana News Agency after a panel discussion on the Ghana Journalists Association programme dubbed: “Business Advocate” on Ghana Television.

The programme was supported by BUSAC Fund, Denmark Embassy and the United States Agency for International Development.

The Director expressed concern about the insurance scheme’s medicine chain management which, he said, was affecting the smooth operations of the scheme, and said the Authority was paying more money for medicine that should not have been paid for

He noted that the delays in the payment of claims to service providers was as a result of high consumption on the part of the citizens, which increased the bill, making it difficult for the Authority to meet the required payment.

“It is incumbent on us as citizens to be responsive and change our behaviour. A lot of people who are registered on the scheme visit the hospital 15 times a day which increases the consumption rate”, he added.

He explained that because the Authority was not able to control prices, medical consumables in the country were the highest in the world, and that the country was the second or third in the world that spent more in paying for medicines that should otherwise not be paid for.

Mr Gingong expressed worry about how most organizations avoid taxes by not issuing the approved Value Added Tax (VAT) receipt, but instead decide to issue the ordinary receipt without VAT which affects the operations of the scheme negatively, explaining that the tax was used to fund the scheme.

He said the capitation grant was necessary because it provided the subscriber the choice to decide which facility to attend, and also allowed the Authority to transfer some money in advance every month to the providers.

Mr Gingong said under the capitation, funds were made available upfront to the various health facilities operating the Scheme for the treatment of their clients, and called on the public to register at the nearest health facility to avoid situations where patients moved from one health centre to another with the same ailment.

He explained that under the system, a client could be treated only at a facility where he or she had been registered, and that the pilot programme revealed that most people sought treatment at health facilities they had not been registered.

Mr Frank Torblu, Executive Director of the Health Insurance Service Providers Association said the NHIS was one of the best social policies for health delivery, but had technical and operational difficulties that needed to be addressed.

He said the country needed to look at the preventive health care services than the curative aspect which involved a lot of money, and urged government to use part of the petroleum levy to fund the Scheme due to the financing gap.

He appealed to parliament to approve the entire budget allocation for the Authority to enable it to perform its functions in an efficient and effective manner.

Mr Benjamin Nii Quaye, Executive Member of the Pharmaceutical Society of Ghana also expressed worry about the delay in the payment of the Scheme’s operational claims which was affecting it negatively.

He urged government to ensure the timely release of funds for the payment of the claims to help improve health care delivery.