Proposed Health Insurance scheme subjected to public scrutiny

A roundtable conference by a cross section of people on the National Health Insurance Bill in Accra on Wednesday was divided over the viability of the proposed National Health Insurance Scheme being capable of addressing the huge financial demands of health care delivery.

The conference, the third, to be organised by the Institute of Economic Affairs (IEA) in collaboration with the Konrad Adenauer Foundation to seek public views about the Bill attracted divided opinion over whether a National Health Fund was not a better alternative instead of the proposed Health Insurance Scheme, which was to be run on experimental basis.

Professor Agyeman Badu Akosa, Director - General of the Ghana Health Services argued for a Health Fund that could be sustained through a health lottery. He said the projected coverage of between 50 and 60 per cent of the people by health insurance over a period of 10 years meant that the Cash and Carry system could not be abolished immediately as promised by the government.

Professor Gilford Amarh Ashitey, a Lecturer at the University of Ghana Medical School was against any form of additional health funding when there were irregularities in the management of the 80 per cent capital flow from the government to the Ministry of Health (MOH).

He suggested the need to streamline the utilisation of such a huge capital and the strengthening of Primary Health Care to check preventable diseases like malaria that was caused by unhygienic conditions.

Professor Ashitey said the MOH should not over burden itself with health care delivery since that called for a multi-sectoral approach. He said a Health Insurance Scheme could only succeed if there was a proper demography of the country's population to determine the beneficiaries of the scheme.

Mr Agyeman Manu, Deputy Minister of Roads and Transport, expressed dissatisfaction about the long time frame of 10 years implementation during, which the scheme could cater for the majority of the deprived.

Mr Kwesi Eghan of the MOH said the vision of the scheme was to ensure equitable universal access to quality basic package for health services. "Every Ghanaian shall belong to a health insurance scheme that adequately covers him or her against the need to pay out of pocket at a point of service to obtain access to a defined package of acceptable needed health services."

He said the scheme was a fusion of the concepts of Social Health Insurance and Mutual Health Organisations operating in some districts. The National Health Insurance Council, General Assemblies and Management Boards that would be in direct contact with the district assemblies would manage the scheme.

Mr Eghan said 40 districts had been selected throughout the country to start the scheme on pilot basis. Mr B.J. da Rocha, Chairman and Senior Fellow at the IEA, said all options must be considered to make the scheme a success, adding, " I do not share the pessimism that the scheme would not succeed". Professor Fred Sai, another Senior Fellow of the Institute, said decentralisation of health care financing was the best form of sustaining the health system.