Patients cheat NHIA

Over a decade into the implementation of the National Health Insurance Policy, intended to make health affordable to underprivileged Ghanaians, patients are defrauding the scheme, according an investigation by DAYBREAK newspaper.

DAYBREAK investigations into the predicament of the NHIA indicate that whilst there is massive potential for the scheme to develop new packages and initiatives for the poor and vulnerable, waste caused by fraud is preventing the NHIA from carrying such transformational changes.

All across the country today, there is a strange phenomenon of duplication cards, including those of several pregnant women who benefit from certain privileges but who are now under different privileges because they have delivered and refused to pick their original cards.

It has emerged, for example, that there are several cases of beneficiaries who have engaged in double and triple registrations across the country even though such people are entitled to just one privilege. Unknown to them is the fact that producing several ID for the same person, as well as files and documentation at various centres, wastes resources, including precious time and funds that scheme managers use to ascertain the veracity of such names and addresses.

The processes and procedures are such that beneficiaries are sometimes handed temporary IDs, which are used for three months before the original ID is ready. Unfortunately, instead of the beneficiaries making use of the temporary IDs, they move elsewhere in and around the country, because the cost of the scheme or premium is cheap, to register at another point, by which time the original ID is ready and being processed and worked on by the facilities in the jurisdiction.

The difficulty faced by the Scheme is that when, for example, the name Yaa Boahaemaa pops up together with her image, several images and faces and names pop up, with probably only a difference in address. Ascertaining which is which takes time, apart from the costs of documentation and stationary as well as printing of IDs.

Because the various beneficiaries fall under identifiable information systems, going round to check and verify these information to determine that the Yaa Boahemaa who registered at Odorkor is the same as the Yaa Boahemaa now on the screen at two other centres in various locations, becomes a difficult and challenging exercise.

In the end, not only is there is delay in processing but also monitoring patients becomes difficult, particularly when the disease reported on is laden with complexities that need referrals and follow-ups.