Weak supervision of the activities of some private health insurers in the country has culminated in unwholesome market pricing policies that are weakening the industry, Anthony Sowah, General Manager of Nationwide Mutual Healthcare, a pioneer in Ghana’s private health insurance sector, has indicated.
Mr Sowah, who disclosed this recently to journalists in Accra, said people suffer immensely because of their patronage of the services of quack practitioners.
Private health insurers are left to operate without any monitoring by the National Health Insurance Authority (NHIA).
Nationwide Mutual Healthcare, the leading brand in private health insurance in Ghana, is 10 years old.
According to Mr Sowah, a lot of private sector insurers did not set their premiums based on sound actuarial calculations but undercut the business of well-resourced providers to jeopardize themselves and the whole sector.
“By virtue of being pioneers and leaders, we have invested a lot into human resources, ICT infrastructure and actuarial resources just to help us with a good analysis of the industry and to help with decision-making.
“Most of the others have adopted a very simple pricing method. They look at what Nationwide is doing and then cut the price by 10 to 20 percent. So when you are about to close a business with a client or renewing a business, the client will then bring out the prices of our competitors and then they are tempted. But we know the sound actuarial basis of arriving at premiums so it becomes difficult for us to come down to the level of those competitors,” Mr Sowah noted.
He called on the NHIA to focus its attention on activities of private insurers.
Mr Sowa noted that patients go to hospital with simple stress-related conditions which require rest or lifestyle management, but some doctors deliberately load the patients with drugs that are expected to expire soon.
Nationwide Mutual Healthcare, he said, has a very strong internal vetting process that begins from the submission of claims and ends with a review by a vetting committee comprising doctors from different backgrounds.
