NHIS: Alive or collapsed? The poor can testify

The National Health Insurance Scheme (NHIS) has for some time now faced serious criticisms from sections of the population.

For those who wish to make political capital out of the situation, they refer to the few challenges of the scheme and conclude that it has collapsed.

Others believe that the NHIS has not malformed but just not living up to its mandate for which it was introduced.

Established by an Act of Parliament in 2003 (Act 650), the NHIS is an initiative by government to secure financial risk protection against the cost of healthcare services for all in Ghana.

Its funding is based on a combination of the following models: National Health Insurance Levy, which is 2.5%, Value Added Tax, 2.5% of Social Security contributions and the graduated informal sector premium based on ability to pay.

Earmarked funds (NHIL & SSNIT) constitute more than 90% of total inflows.

The scheme has free registration and access to healthcare for the poor and vulnerable, thus preventing catastrophic health expenditures and poverty. This is tailored towards addressing the Millennium Development Goal One (MDG1), which is focused on reducing poverty and hunger.

Child mortality, which is being looked at under MDG4, is not left out under the NHIS as all persons under 18 years have free access to health insurance. The under-18 represents almost 50% of registered members as of December 2012.

The scheme also has a free maternal healthcare policy introduced in July 2008 for pregnant women. Maternal health is a concern under MDG5.

Malaria, tuberculosis, HIV and other opportunistic diseases are equally covered by the NHIS, which MDG6 seeks to address.

With all these, one could confidently say that the contribution of the NHIS towards Ghana’s quest to meet the MDGs is very significant.

The unending queues at the various offices of the scheme to grab the new biometric identification cards still go to explain how important and valuable the NHIS is to the people.

At Wa Municipal NHIS office, production of the new biometric card is efficiently going on for some months now, yet the queue still persists every day.

People wake up as early as 4am to queue, just to enable them get the card to access free healthcare.

This explains that the NHIS is still alive and playing its role despite the few obstacles. If indeed the NHIS has collapsed, as some critics want us to believe, people would not go through such ordeals to get a card which would not be of any benefit to them.

Many of these commentators probably are people who do not want to pass through the queues at the public health facilities and often seek healthcare at private hospitals.

It is a fact that since the introduction of the NHIS system, attendance to the Out-Patient Department has increased across every health facility.

Special Registration

The scheme, as part of its mandate, introduced the free special registration for all vulnerable groups in society to enable them get registered and have access to free healthcare.

A practical example is the Wa Municipal NHIS, which registered a total of 165 inmates of the Wa Central Prisons.

The free special registration exercise also covers 135 basic schools, with total population of 34,284 students under the school feeding and free school uniform programmes.

The gesture includes pregnant women, pupils in orphanages and special schools such as the Wa School for the Blind and the Wa School for the Deaf, as well as beneficiaries of the Livelihood Empowerment against Poverty Programme in 40 communities within the municipality.

Madam Celine Saayeng, the Municipal NHIS Manager, explained that the initiative was aimed at ensuring all vulnerable groups are enrolled free of charge onto the scheme to enable them have access to free, quality healthcare services.

“People who are poor and vulnerable and cannot afford to register themselves should not be denied the opportunity to access free healthcare but rather should be assisted to register and also enjoy the same services enjoyed by those who can afford,” she said.

Madam Celine said ensuring equity in healthcare services is very paramount for the NHIS, hence its resolve to make sure that continues to be a reality, especially for the most vulnerable and less privileged in the society.

Without the NHIS, the poor, the vulnerable and the less privileged in society would be cut off from quality healthcare services, and this would have had a dangerous effect on the country.

The value of the NHIS is better known to this group of people and they can better tell the story of the NHIS, and not the other way round.

One must admit that the NHIS, just like other public organisations, is currently facing some challenges, but the government, together with National Health Insurance Authority and the managers of the various schemes, is doing its best to sustain the scheme and deliver the mandate.

For me, if the NHIS is only able to provide free, quality healthcare to the poor, the vulnerable and the less privileged in the society, it needs to be praised.

The NHIS is still alive. What it needs is help for it to overcome its challenges and deliver fully on its mandate, and not castigations.