NHIS on the verge of reducing deficit

By Alhaji Alhasan Abdulai

After visiting a number of health provider outfits, that include hospitals and clinics in the Greater Accra and some towns and villages of the country, we have come to the conclusion that the National Health Insurance Scheme (NHIS) is very much alive and kicking. Although we hear of some subscribers of NHIS complaining about some shortcomings with the scheme those very people are seen using the NHIS cards to acces medical care in hospitals and clinics. All that anybody needs to do to ascertain the truth about this matter is to visit the Achimota Hospital, the Ashongman Estates Community Hospital and the Mamoobi and the Adabraka Hospitals and they would find large numbers of citizens of Ghana young and old men and women wielding proudly the NHIS cards. Apart from using the cards to go through consultations those in possession of them are given drugs, injections with some of them having to go through laboratory tests. Those who are hospitalized overnight do not pay for their stay in the hospitals and clinics. It is true that some of the health service providers find it difficult to get paid regularly and on time for services rendered to clients of NHIS this was explained away by the authorities of the NHIS. It is due mainly to the rather increase in the number of people who access medical care and other factors and the resultant build up of the cost of medical care. However the NHIS has taken steps to deal with increase in bills from the service providers. One of the methods being used by the scheme is the introduction of capitation plan in which all subscribers are to choose one service provider of his or her choice at a time. This way the subscribers would stop moving from one service provider to the other thereby swelling the cost of medical care under the scheme. This method which began on a pilot in the Ashanti Region is now being practiced in the Northern, Upper West and East and Volta Regions. It would soon be extended to other parts of the country including the Greater Accra Region being the largest part of the country in terms of population.

The increase in number of subscribers of the scheme resulting in increase in debt owed by the scheme has led to some service providers agitating payment from NHIS monies owed to them by the scheme. As promised the NHIS has begun settling its indebtedness to the service providers with a plan for a long term measure to close the gap on payment periods to the service providers.

In an interview with citi Fm’s Bernard Avle in Accra the Chief Executive Officer of the National Health Insurance Authority (NHIA) Nathaniel Otoo has given assurances that the authority is currently working at reducing the deficits in the scheme to make it more effective.

“The NHIA’s expenditure has been consistently exceeding its income for the past six years and this situation has created huge deficit gaps for the scheme”. He said

According to Mr Otoo, “the NHIA will be focusing its efforts on improving forecasting strategy and reining in costs adding that the operational expenditure of the NHIA will stagnate or reduce this year”.

The NHIA boss indicated that forecasting was key to addressing the deficit gap and this, coupled with non-traditional sources of income, will help in closing the deficit gap.

“The more accurate we are in forecasting, the better we can tell where the gap will be adding that We have been able to improve on our forecasting and because we are getting small amounts of income from non-traditional sources we are going to make progress in our finances

The National Health Insurance Scheme is a form of National health insurance established by the Government of Ghana, with a goal to provide equitable access and financial coverage for basic health care services to Ghanaian citizens.

The health insurance scheme was set up to allow Ghanaian citizens to make contributions into a fund so that in the event of illness Ghanaian contributors could be supported by the fund to receive affordable health care.

Like all insurance schemes, the scheme was designed to promote shared responsibility in which premiums are charged for different payments to be made annually giving the very old people and children under 18 to pay lower premiums. To ensure that all Ghanaian citizens made some contribution to the scheme apart from deductions for the scheme made from workers pay throughout the country, a 2.5% Health Insurance Levy on selected goods and services was passed into law so that the money collected could be put into a National Health Insurance Fund to subsidize fully paid contributions to the District Health Insurance Schemes.

A serious look at the situation shows clearly that the current Chief Executive Officer of the scheme and his workers are working around the clock to realize the goals of the scheme to provide medical care to Ghanaian subscribers of the scheme in all parts of the country. What is needed is for all Ghanaians including the government and the service providers to provide the scheme with the needed assistance needed for it to make progress. All subscribers of the scheme must go to hospital only when they are sick. The service providers on their part must also provide bills on the number of people they have treated. Any attempt to inflate the cost of medical care on the scheme is not proper. Since the scheme was created to promote shared responsibility in payment of medical care, it is only fair that all those involved in the scheme would play their parts in accordance with the law setting up the scheme.

EXECUTIVE DIRECTOR

EANFOWORLD FOR SUSTAINABLE DEVELOPMENT

0244 370345/ 0274853710/0208844791

abdulai.alhasan@gmail.com/eanfoworld@yahoo.com