NHIS benefit package needs reform – stakeholders

Participants at the NHIS Stakeholder Dialogue on Thursday called for a reform in the benefit package offered to card bearing members of the scheme. The benefit package is simply defined as a basket of health conditions covered under the scheme and offered to scheme subscribers. The stakeholders, who unanimously called for a benefit package review that will ensure a more sustainable scheme, mentioned that the next phase of NHIS’ growth should consider placing a ceiling on the benefits.

The scheme now covers 95% of all reported diseases in the country.

Others at the forum also asked for a reconsideration of NHIS’ exemption policy. Under the current NHIS law, some 70% of subscribers do not pay premiums because they fall within the exempt category. These include persons below 18 years old, pregnant women, SSNIT contributors, SSNIT pensioners, indigents and people above 70 years of age.

A section of the forum also opined that the NHIS must take seriously the subject of equity in reviewing its benefits package because according to them, the scheme must focus on reaching more people especially the poor and not necessarily focusing on uncommon and expensive treatments.

While it was largely said that one of the strongest points of Ghana’s scheme is its cross-party political support, it was mentioned that additional funding to the NHIS should be considered as a matter of urgency since the scheme has grown over the years to over 10 million subscribers with the attendant costs that come with such growth. It was suggested that an increase in the current 2.5% NHIL by 1.5 percentage points, the allocation of about 20% of the communications service tax to the NHIA, a reconsideration of the exemption policy of the scheme among other things, could help extend the scheme’s sustainability period.

Others at the forum also suggested that its about time the NHIA considered introducing co-payment to help check abuse of healthcare and also to raise additional funds for the running of the scheme.

Chief Executive of the NHIA, in addressing the gathering stated that the scheme has grown over the last ten years and the “time has come for us to re-look at our benefit package in a manner that will ensure quality of care and make the NHIS buoyant.”

He mentioned that the NHIA has introduced a raft of measures to make the scheme increasingly efficient and these efforts were yielding good results. Mr Mensah mentioned the establishment of 4 zonal Claims processing Centres to professionalize claims management, the creation of the Consolidated Premium Account, the introduction of the instant ID card based on biometric data, capitation, electronic claims processing and a host of others, as measures introduced to make the scheme more efficient.

A deputy finance minister, Ms Mona Quartey, assured the gathering that her outfit will ensure the timely release of funds to ensure the scheme is sustained.

The dialogue was under the auspices of the Minister of Health, Dr Kweku Agyeman-Mensah.

The stakeholder forum was organized to discuss the over 10-year-old NHIS benefit package with the view to eliciting responses and views from stakeholders to make the package more equitable, evidence-based and sustainable. The forum was on the theme, “an equitable and sustainable benefit package based on evidence.”

In attendance were many former health ministers including Dr Kweku Afriyie, Dr Richard Anane, Hon Joseph Yieleh Chireh and Hon Moses Adibo.

Hon Mona Quartey, a deputy Finance Minister and Dr Victor Asare Bampoe, deputy health minister, Dr Kwabena Opoku Adusei, President of the Ghana Medical Association, Dr Ebenezer Appiah-Denkyira, Director-General of the Ghana Health Service, Hon Matthew Opoku Prempeh, MP for Manhyia South, Dr Gilbert Buckle, CEO of the Korlebu Teaching Hospital and a host of other people also participated in the program.

The event, was also attended by health policy experts from the local and international arena, researchers, people from business and academia, various provider groups and civil society.