Our attention has been drawn to an ad currently being aired on a number of TV stations. The said ad opens with a mother rushing to a clinic with an NHIS card to seek medical treatment for her child. The mother was surprisingly turned away by two nurses at the clinic with a pretext that the NHIS card is not as effective as it was in the past.
The National Health Insurance Authority (NHIA) finds this advert very disturbing and disingenuous. Our view is that the ad has been crafted to weaken public confidence and cause disaffection for the NHIS. This is harmful and could run down one of the most successful pro-poor mechanisms the people of Ghana have in accessing healthcare.
Thankfully, the facts are very different from what is being portrayed. Many more people are thronging various NHIS accredited health institutions across our country and are treated simply because they are card-holding members of the scheme. In fact, it is illegal for any nurse or health professional in any accredited facility to turn any member away in the manner expressed in the advert. Utilization, which is the term, used to describe the number of times card-holding members attend healthcare facilities, has seen a remarkable increase. Clearly, the NHIS is active and not a collapsing scheme.
Service providers now receive their reimbursements in an average of 60 to 90 days instead of the 7-8 months it used to be. A modern Claims Processing Centre was established in 2010 to further expedite the claims payment process. All these are done to ensure subscribers of the scheme are given the best of care at healthcare facilities and receive value for their money. The subscriber is at the heart of our operations.
Available data suggest that revenue generated by health institutions as percentage share of cash versus NHIS payments has tilted heavily towards the later. In 2006, about 80% of internally generated funds (IGF) from public hospitals came from cash payments, popularly called cash-and-carry, while only 20% of the total revenue base came from the NHIS. However, in 2010, NHIS payments to those same health facilities rose to over 80%, while cash-and-carry payments dipped to less than 20%. The lowest since the NHIS started. Accredited private health institutions have also seen considerable increase in the number of people who visit those facilities. This is the mark of an active scheme.
Instead of endorsing the few unscrupulous health professionals who may illegally turn patients away for mischievous reasons, such bad acts should rather be reported to the Authority for immediate action. For this reason, the NHIA established a call centre this year to address all issues and complaints relating to subscribers and their service providers. The numbers which have been widely publicised are 054 444 6447 and 0302 74 6447. This is clearly a scheme that is responsive and delivering on its mandate and not a collapsing scheme, as others will have us believe!
The successes of Ghana’s NHIS have never been disputed. It is therefore sad that some people, for reasons best known to themselves will resort to all means possible to discredit a life saving program like the NHIS. Notwithstanding the new found method of launching attacks on the NHIS, many countries and international organisations still find the NHIS attractive enough to learn from. Tanzania’s visit to the Authority just last week is testament to the fact that the scheme is vibrant and a good example to many. If the scheme were dying as is being portrayed in ads and on political platforms, foreign governments will not send delegations on study visits of our health financing mechanism. The scheme is certainly more vibrant and active.
Those peddling falsehood about the sustainability of the NHIS need education. They appear to be quoting out of context a report authored by the World Bank, titled “Health Financing in Ghana.” It is surprising that only one line from the 196-page research report which otherwise generally paints a good picture of the NHIS, is being disseminated to achieve political objectives. The same report under its key findings observed that “consumer satisfaction with the NHIS is high.” It also said the NHIS has “reduced financial access barriers to health care” and increased utilization of health service.
The August 2012 World Bank report also extolled Ghana’s chosen mechanism for financing healthcare stating that the “system is going in the right direction’’ subject to commitment to international good practices. The question is why have the crafters of the doomsday messages refused to see all the above as detailed by the same report? The report, which is largely fed by data from the period between 2005 and 2009, also makes reference to structural, operational and financial inefficiencies in the NHIA. Why are we not discussing these too? The answer is clear.
We as managers of the NHIS remain focused on our core mandate of working to provide financial risk protection and ensuring financial access to healthcare for the people of Ghana. We refuse to be distracted by the attempt to weaken our resolve. We further wish to assure the general public and our subscribers and other stakeholders that the future of the NHIS is bright and the scheme is healthier and stronger today than before. Each passing day sees innovations and reforms to ensure that our stakeholders are given the best of service for sustained satisfaction. Indeed these ads are unprofessional as they are unethical and must be stopped.