NHIS not sustainable without private involvement – Awuah-Darko

The Executive Chairman of the Nationwide Medical Insurance Company Limited, Harold Awuah-Darko, says considering the untenable state of the National Health Insurance Scheme (NHIS), it is important for the private health insurers to support it.

“The current state of the National Health Insurance Scheme (NHIS) was not sustainable and this is evident in the backlogs of claims owed to its healthcare service providers across the country. The claim costs have consistently outstripped revenues as the scheme has registered more people and utilisation rates have gone up”, he argued.

Mr Awuah-Darko was speaking at a ceremony to unveil a new product by Nationwide Medical Insurance Company Limited dubbed “My health”, the first ever micro-health insurance plan in Ghana, is aimed at meeting the essential healthcare needs of persons in the informal sector.

He further explained that the NHIS scheme received a fixed income from the National Insurance Levy (NHIL), SSNIT contributions and membership fees from which it paid the medical expenses for its members.

Consequently, he said, as its membership grew, its revenue per member decreased, resulting in a lowered capacity to pay for healthcare services rendered to its members.

The NHIS service providers have in the recent past threatened to boycott supplies to the scheme over outstanding arrears. The scheme owes service providers to the tune of GH¢1.2billion.

Mr Awuah-Darko said the introduction of the new product was the beginning of efforts by the company to deepen the health insurance penetration in Ghana.

The Nationwide Medical Insurance Company Limited has launched a new product which seeks to offer comprehensive health insurance for persons in the informal sector.

The package seeks to offer subscribers a reliable and efficient access to healthcare services on flexible payment terms which could be made daily, weekly, monthly, quarterly or yearly.

“Increase private health insurance participation”

According to Mr Awuah-Darko, the solution to the challenges of the NHIS was increased participation of the private health insurance to wean off the burden on the scheme.

“This would take Ghanaians and other residents, who can afford private health insurance, off the NHIS, resulting in more resources available from the NHIS to Ghanaians who cannot afford the private health insurance”.

For that to happen, the executive chairman said the laws and regulations governing the health insurance industry needed to be amended, adding that the monopoly the current law gave to the NHIS by making it mandatory for all Ghanaians and other residents to be members of the NHIS before subscribing to other private health insurance needed to be taken away.

He further recommended that an independent regulator be established for the health insurance industry.

The package

The Business Development Manager of Nationwide Medical Insurance, Mr Isaac Nartey, speaking on the new product said the insurance package targets the informal sector because it is the largest segment of the Ghanaian workforce, representing about 85 per cent of the total workforce.

Nonetheless, he said, the private health insurance had ignored the sector and concentrating on the remaining 15 per cent who were in the formal sector.

Mr Nartey explained that the health insurance plan could be subscribed by individuals, families and members belonging to groups and associations such as churches, trade unions, transport associations, mosque and schools.

Under the package, subscribers enjoy healthcare benefits such as prescribed drugs, maternity care, medical consultation, diagnostic investigations, hospitalizations and surgery care.

In addition, Mr Nartey noted that the company was collaborating with Roche, a pharmaceutical company, to offer healthcare benefits to women who were diagnosed of breast cancer as part of the new package.

What made the package unique was its affordability, breast cancer reimbursement, efficient accessibility, he said, adding that financing of breast cancer diagnosis and treatments had become a major concern of most women.

Package is commendable

The President of Breast Care International and CEO of the Peace and Love Hospitals, Dr (Mrs) Beatrice Wiafe Addai, commended the company for including healthcare benefits to women, who were diagnosed of breast cancer, to the new product, adding that, due to the expensive nature of the treatment of breast cancer, most women died.

Delivering the keynote address, the former Chief Executive Officer of the Korle Bu Teaching Hospital, Dr Gilbert Buckle, said although the NHIS was making the effort, there was room for the private sector to introduce innovative ways to provide quality health insurance services to Ghanaians.