NHIS To Suffer Hiccups?

-Additional Funding Needed

The National Health Insurance Scheme may suffer serious hiccups in the coming years

if additional funding is not provided soon to top-up the present sources of funding

for the scheme. In a media interaction with the Chief Executive of the National

Health Insurance Authority last Monday, he re-iterated the need for additional

funding to shore up the finances of the scheme if it must continue to support the

healthcare needs of people resident in Ghana.

“At a time when both members and providers attest to the positive impact of the

Scheme on their health, services and businesses, there seem to be a sustainability

challenge which must be addressed in the 2011 budget” he said .

Mr. Sylvester Mensah, Chief Executive of the NHIA, said anything less than the

equivalent of a 1% increase in the National Health Insurance Levy(NHIL) would throw

the scheme, providers and members into an era of reduced healthcare financing

services in 2011 and beyond.

Mr. Sylvester Mensah said, “The scheme would be constipated, crippled and eventually

disabled if measures are not taken to provide additional funding”.

Despite the fact that Ghana’s GDP has not grown as much as the growth in NHIS

utilization and growth in medical inflation, the main source of funding for the NHIS

since inception has been 2.5% of VAT sales called the National Health Insurance Levy

(NHIL). As a social protection initiative, about 70% of members – including the poor

and expectant mothers – do not pay premium.

Mr. Sylvester Mensah explained that his administration inherited arrears of about

GH¢ 115 million from 2008. In that same year, 2008, disinvestment of the National

Health Insurance Fund started and has continued to date. Between January 2010 and

September 2010 alone, a total of about GH¢ 146 million has been disinvested. He

added that current investment cover is less than 6 months, beyond which there would

not be enough income to fully cover the over 65% of Ghanaian residents who are

members of the NHIS.

As part of cost containment measures, the NHIA created a clinical audit division

which has so far recovered over GHS 16 million from past payments.

The statistics indicate that in 2005, when membership of the scheme was only 1.3

million, the NHIS was paying approximately GHS 20,000 per day as claims. Today, with

over 15.5 million registered members and 95% of diseases covered, the scheme is

paying close to GHS 1 million per day as claims. Between 2008 and 2009 alone,

utilization increased astronomically by 75% from 10 million visits to over 17.5

million visits.