Four key measures are being proffered by the National Health Insurance Authority (NHIA) to make the Health Insurance Scheme sustainable. These measures according to the Chief Executive Officer for the NHIA, Dr Samuel Annor, is fundamental to the sustenance of the scheme.
At a consultative meeting with the Trades Union on Monday February 7, 2018 at the Shippers Authority in Takoradi, Dr Annor notes a review of the scheme has been taken to resolve current and potential crisis that might befall the scheme.
He mentions a formulation of new financing module, automation of insurance claims, internal –policing and constitution of a legal framework are paramount to an effective and efficient management of the health insurance scheme.
Dr Annor, insists the country has to ward off any political interference and work at eliminating corruption from the NHIA. He charged Ghanaians to contribute to the success of the scheme as well as demand accountability form duty bearers.
“Let us depoliticize the NHIS, let us make it a no go area for any corruption or whatsoever, let us feel ownership of the scheme. Let us know what it is doing? What are the books like? How much money did we raise? How many people did we save?”
Let’s be conscious of the NHIA. Because when the whole nation is quiet, it would seem that the whole nation is not interested in their health, he charged.
Among the reformations to make the NHIS sustainable, the authority claims the current financing module under the scheme is woefully inadequate. According to the CEO, Dr Annor, the 2.5% NHIS levy on VAT and the 2.5% SNNIT constitute about 95% of the NHIS Fund. Dr Annor contends only 30% of NHIS beneficiaries are allowed to pay premiums.
He opines the country’s spend per head under the scheme is hugely deficient on what is required by international practices.
“There’s been an international review and the suggestion is that for you to provide basic primary healthcare, you will need about $86 per person per year. Slightly more than more basic healthcare, probably we should be targeting about $100 per person per year. Now, we are about it, and we are trying to move from $30 upwards. So you must appreciate the gab is big”
He stressed the module has outlived its effectiveness in funding the NHIS.
On this background the CEO, sought to recommend the constitution of a Health Tax on some commodities like sugar, cigarette, alcohol among others that makes us prone to some illnesses.
Dr Annor proposes government increases VAT allocations to the NHIS by at least 1%.
Automation of claims.
NHIA receives on annual basis about 30 million claims from its service providers. Currently the authority processes about 90% of NHIS claims by service providers. Dr Annor avers the existing processing mechanism is inefficient and outdated. He explains the NHIA does not have a sufficient IT system to interrogate claims sent them by service providers.
He opines the human interference with the system is enormous and thus breeds corruption and other malpractices.
We need to sort out and stop that manual processing of claims. That is so key and we are determined, that has to be done, he charged.
The Chief Executive Officer mentions the need for a strong internal police force cannot be underestimated in every human institution. He says these mechanisms are put in place to check on potential human interference with the health fund.
This internal police force by their activities are supposed to make it difficult for people to temper with our money in the health box. And those who temper must be brought to book and justly judge to an extent that it acts as a deterrent for people who are planning or thinking of going to temper with our money in the health box, he elaborated
He adds the current internal police system with the NHIA is very weak.
According to Dr Annor, a strong and effective internal police force must draw on a legal framework. He says the inexistence of a legal framework on the operations and conduct of public servants in the authority makes it prone to wrongful undertakings.
He proposes the framework is structured such that it would be deterring enough for perpetuators of crime with the NHIA.
TUC demands accountability.
Secretary General of the Trade Unions Congress, Dr Yaw Baah says the various unions are conscious of their contributions to the sustenance of the NHIS. He admits the various propositions made by the NHIA, are in good faith, members of the various trade union are more critical of how their monies are put to use.
Dr Baah stressed organized labour as part of the reformation process in the NHIA demands a degree of representation on the NHIA board.