The President’s technical committee tasked to review the National Health Insurance Scheme (NHIS) has recommended a guaranteed universal primary healthcare basket for all residents in Ghana.
The committee has also proposed that, given the strides the country has made in maternal and child mortality and morbidity, a package of maternal and child healthcare should also be guaranteed, to consolidate those gains.
This is the first ever major review in the 13-year history of the scheme.
Chairman of the technical committee, Dr. Chris Atim who revealed this on Tuesday at a national stakeholder consultative meeting in Accra said, “the fundamental premise of this redesign is that, the NHIL (or earmarked 2.5% VAT), which is the most important source of financing for the NHIS, is collected from all Ghanaians, and should be used to fund services that benefit the whole population and not a minority as at present.”
[contextly_sidebar id=”Kxu1qh3ob6OlJzCGTyNpKQ6zTbkJqJUL”]The proposal which categorizes the benefit of the NHIS into a two-tier system, thus guaranteed primary healthcare and secondary-tertiary healthcare, states that NHIS cards will only be required when seeking care outside the defined primary healthcare basket which essentially are conditions in the second tier of the proposed redesign.
“The committee’s recommendation of a universally guaranteed primary healthcare package of services, if accepted, means that possession of the NHIS card will no longer be necessary to access this primary healthcare package, though identification will still be required. Membership of the NHIS will only be required if the service sought by a person is outside the primary healthcare basket,” Dr Atim averred.
According to the committee, in order that this recommendation of universal access does not lead the NHIS to the same pitfalls of the free healthcare system of the immediate post-colonial era, individuals must identify themselves at the health facility with any recognized national identification card in order to access this universal package. This is to help track utilization, data about which the providers must transmit to the NHIA whether the service is capitated or not, and to minimize abuses of the system.
The review, according to the committee, provided the opportunity to refocus the NHIS and by extension the country’s health systems to current efforts to expand and improve primary healthcare access.
The proposed package also will ensure that the Scheme applies its limited resources more equitably and address the current issues of claims reimbursement delays while safeguarding quality and all-inclusiveness.
By this recommendation, the review committee was “seizing the opportunity offered by government’s ongoing focus on CHPS zone expansion and reinforcement to re-direct public resources and efforts principally towards primary health care.”
Committee proposes Patient Protection Council
The committee further proposed that a Patient Protection Council, endowed with statutory powers independent of the NHIA and the provider groups to defend the rights of patients and members, be established.
According to the committee, the Council will help address issues of abuse of patients’ rights among other things, as “focus group surveys conducted for this review show categorically that the public currently does not believe that scheme members are respected or treated with dignity.”
Dr. Atim argues that the establishment of the Council will be in furtherance of building an actively informed and involved membership. “It is our conclusion that members will be more inclined to protect the scheme against abuses if they feel their own interests are protected.
“This council’s role will among other things be to promote the quality and safety of heath care, as well as transparency and compassionate care. It will strive to ensure that members are respected and feel dignified not only at health facilities, but also at NHIS offices.”
NHIA must explore innovative means of financing
Vice President of the Republic, His Excellency, Paa Kwesi Amissah-Arthur, who opened the consultative meeting said though government’s finances were over-stretched, they were still committed to expanding coverage and sustaining the scheme.
According to him, in spite of the financial constraints, government would not abandon the pursuit of seeking quality health care for the people for sustainable national development.
Mr. Amissah-Arthur stated that the NHIS formed an important part of the country’s social protection strategy and his government’s commitment to the scheme was unwavering. He emphasized the fact that the sustainability and improvement of the NHIS required the active involvement of the private sector in the provision of health infrastructure.
He called on stakeholders and the NHIA, to explore means of innovative financing to complement state resources in funding the scheme.
Finance Minister, Hon Seth Terkper who was also present at the function underscored the importance of a viable and sustainable scheme and drew a correlation between a healthy population and national development.
Sector Minister, Alex Segbefia, in his remarks assured stakeholders that government was proud of the scheme and would continue to work to sustain it.
NHIS funding gap
The NHIS has been running a funding gap since 2009, a situation which arose because of what experts say are design and structural weaknesses of the Scheme.
Cost of providing medical care, the Minister said has increased exponentially since the Scheme started full operation in 2005.
According to him, the fact of commissioning the review was a bold one and indicative of government’s commitment to ensure the scheme works and remains relevant to the health care needs of the country. He praised the technically independent nature the review has taken and also lauded the bi-partisan support the work of the committee has received.
According to him, this remains a proposal by the committee and upon a presentation of a report to the President who commissioned the review; a decision will then be taken on the way forward in respect of the recommendations.
Composition of the Review Committee
The technical team is chaired by Dr. Chris Atim, a senior health economist and Executive Director of the African Health Economics and Policy Association (AfHEA).
Other committee members include Dr Victor Bampoe, Deputy Health Minister, Dr Obeng Apori, immediate past Chief Executive of the Ridge Hospital, Accra and Mr Peter Yeboah, Executive Director of the Christian Health Association of Ghana (CHAG).
The rest are Prof Irene Agyepong of the School of Public Health, University of Ghana, Dr Huihui Wang, an Economist with the World Bank and Nathaniel Otoo, acting Chief Executive of the NHIA.
The technical team is supported by an Advisory Committee made up of local and international experts, academia, legislators, civil society and provider representatives.
They include Hon Joseph Yieleh Chireh, MP, Hon Dr Richard Anane, MP, Hon Mohammed Muntaka, MP, Hon Dr Matthew Opoku Prempeh, MP, Prof Agyemang Badu Akosa, former Director-General of the Ghana Health Service, Prof Frimpong Boateng, formerly of the Korle bu Teaching Hospital, Hon Nuamah Donkor, a past Health Minister and 11 others.
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By: citifmonline.com/Ghana