The Minority caucus in Parliament has repeated charges of incompetence against President John Dramani Mahama and his government, claiming the National Health Insurance Scheme has virtually collapsed because of the regime\u2019s ineptitude.<\/p>\n
The minority said this at a press conference addressed by William Kwasi Sabi the\u00a0MP for Dormaa East on Wednesday.<\/p>\n
According to them, the government\u2019s failure to release funds meant for the NHIS, has suffocated the scheme to such a point that even the NHIA boss, Sylvester Mensah, has admitted that the scheme is near death.<\/p>\n
They further accused the government of\u00a0 destroying all the social interventions introduced by the NPP government during their 8 years in office.<\/p>\n
Find below the full press statement issued by the Minority
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PRESS CONFERENCE BY THE MINORITY CAUCUS IN PARLIAMENT ON NON PAYMENT TO HEALTH CARE PROVIDERS BY THE NATIONAL HEALTH INSURANCE AUTHORITY OF GHANA<\/b><\/p>\n
I thank you on behalf of my colleagues for responding to our invitation. In the year 2003 the Kufuor administration introduced the National Health Insurance Scheme (NHIS) to create financial access to health care for all people living in Ghana especially the poor and the vulnerable.<\/p>\n
The objective of the NHIS was and is to ensure that one\u2019s financial status will not be a hindrance to accessing the needed healthcare. The Scheme worked very well and was acclaimed as one of the best social interventions a government has instituted in the Sub-Sahara African Region.<\/p>\n
However, ever since the NDC government took over the administration of Ghana the NHIS has seen huge decline and deterioration.<\/p>\n
Membership dropped drastically from almost 65% coverage of the Country\u2019s population in 2008 to less than 35% in 2012. Since then coverage of the NHIS has not picked up to the 2008 coverage level again. Health care providers who provide health services to insured clients are not paid and sometimes payments are in arrears over six months.<\/p>\n
The Minister of Finance has refused to transfer funds i.e. NHIS levy and SSNIT contributions made by Ghanaians to the NHIA as stipulated in the NHIS Law, Act 852 section 52. Indeed as of May 2014 the NHIA owed health service providers GH\u00a2213.2 million as a result of which the then Minister of Health indicated to the Minister of Finance by a letter dated June 2, 2014, that \u201chealth providers are not able to provide the needed services to the people and many of them have threatened to pull out of the National Health Insurance Scheme and resort to cash and carry system\u201d.<\/p>\n
This together with inefficient management has resulted in the NHIA\u2019s inability to pay health care providers in this country. This bizarre handling of the Health Insurance Scheme has culminated in the suspension of services to NHIS clients by the Christian Health Association of Ghana (CHAG).\u00a0 The NHIA is indebted to CHAG member institutions for average periods of 5 to 6 months.\u00a0 Many of the staff members of CHAG institutions are paid by the institutions\u2019 internally generated funds (IGF). Since the NHIA is unable to pay the health institutions, they are also unable to pay their staff.<\/p>\n
CURRENT SITUATION<\/b><\/p>\n
Over the past five years the NHIA incessantly has delayed payment of claims to service providers. Further, there is a loud complaint that the tariffs are low as they have been negatively affected by inflation and currency depreciation and hence they are not able to cover costs of providing health care to clients. Meanwhile, the NHIA is unduly delaying in reviewing these tariffs and prices of medicines covered under the NHIS benefit package. For example, the last review of medicines tariffs was done in March 2013 whereas that for the Ghana Diagnostic-Related Groups (G-DRG) was done in 2012 something that is supposed be done within short intervals,\u00a0 at least every 6 months, and that is assuming the economy was stable. The bad management of the economy has resulted in massive depreciation of the cedi, high interest rates, increased minimum wage, etc the combined effect of which have been the sharp increases in the market prices of goods and services. This together with the increase in VAT rate to 17.5% have affected the cost of medicines including those which previously were not \u201cvatable\u201d. The situation has made it very difficult for health institutions to remain in operation, since the process are not only unremunerative but as well they are not financially compensatory.<\/p>\n
The current Capitation model of payment to health care providers is also defeating the national policy on primary health care and reducing geographical access to quality health services in rural and hard to reach communities because the available clinics are unable to continue to provide services.<\/p>\n
NO FUNCTIONAL CONTRACT BETWEEN NHIA AND HEALTH INSTITUTIONS<\/b><\/p>\n
There is supposed to be individual contracts between the NHIA and each health institution that provide services to NHIS clients. This contract spells out the conditions under which the two parties will operate. The current situation, unfortunately, allows for some degree of arbitrariness on the part of NHIA which has refused to sign contracts with some of the health institutions. The NHIA, in the circumstance, dictate what they want to do to the healthcare providers. This has been to the detriment of CHAG institutions since the NHIA assumes no liability for not fulfilling its part of the partnership such as scheduled payments and economic tariffs.<\/p>\n
IMPACT ON HEALTH INSTITUTIONS AND ON THE PEOPLE OF GHANA<\/b><\/p>\n
Ladies and gentlemen of the Media, it is important to cataloged the impact of these adversities on health providers as well as on the people of Ghana:<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The hospitals and clinics are unable to meet their financial obligations, in particular, the payment of salaries of non-mechanized staff.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 There is an increasing shortage of essential medicines, medical and surgical supplies owing to suppliers refusing, and legitimately so, to grant further credits to these institutions due to non- payment of outstanding bills.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Patients are compelled to take prescriptions to purchase medicines from private pharmacies and chemical shops outside the hospital premises even in emergency situations which affect the effectiveness and efficiency of healthcare delivery. This increases the out-of-pocket expenditure on health care by citizens and therefore defeats the purpose and fundamental principles of a Health Insurance Scheme.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hospitals and clinics are resorting to bank overdraft facilities for the funding of essential drugs and medical supplies against very unfavourable bank interest rates in these inflationary times, making the actual cost of health services to increase.\u00a0 It should be noted that these additional costs are not captured or covered by the NHIA which caused the situation in the first place.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hospital managers are being harassed by their creditors and are often threatened with court actions.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Many Ghanaians have lost confidence in the NHIA and have refused to either register or renew their membership with the scheme. Indeed, it has become unattractive to go the hospital with an NHIS card.<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Patients who seek medical care from health facilities are either being asked to make \u2018top-up\u2019 payments or they are refused services<\/p>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Many patients especially the poor and the vulnerable who were the main targets for introducing the NHIS in Ghana, are dying as a result of these issues.<\/p>\n
COVERAGE OF CHAG HEALTH SERVICES<\/b><\/p>\n
CHAG institutions are mostly located in the rural and deprived areas where usually government healthcare facilities are not available. Such areas are also not attractive to the private health investor. Hence, by refusing to accept the NHIS card, the majority of Ghanaians are going to suffer by not having access to health care services. CHAG hospitals serve as district hospitals in so many districts in the country. CHAG has 187 Hospitals and clinics spread across the length and breadth of this country.<\/p>\n
For some regions such as the Brong Ahafo, CHAG institutions remain the main health service providers, hence, by suspending services to insured clients, most people in such regions are denied health care services.<\/p>\n
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GOVERNMENT\u2019S REFUSAL TO LISTEN<\/b><\/p>\n
CHAG has on many occasions sought to resolve this matter with the NHIA, the meeting with the\u00a0 Minister of Health (in February, 2014) and the Finance Minister (in January, 2014) being cases in point. It appears that the pleas of CHAG on these several occasions fell on deaf ears.<\/p>\n
CHAG gave a full month\u2019s notice to both government and the general public of their intent not to accept NHIS card.\u00a0 Neither the NHIA nor the sector Minister ever reacted in any way to this notice or warning. Today, it is the subscribers, the hoping-against-hope Ghanaians who are suffering. To all intents and purposes, the John Mahama administration has no concern for the plight or welfare of the people of Ghana.<\/p>\n
ISSUES AND QUESTIONS<\/span><\/b><\/p>\n -Did the NHIA hear of the impending action by the CHAG?<\/p>\n – What actions were taken to resolve the issues?<\/p>\n – Why should Ghanaians who have paid their taxes and premiums to the NHIA suffer like this?<\/p>\n – Does the current Management have the competence to manage the NHIS?<\/p>\n – Why has President John Mahama kept quiet all this while in the face of such abysmal performance by the NHIA?<\/p>\n – How many Ghanaians is the NDC government waiting to die before they take action?<\/p>\n – If President Mahama could raise three million US Dollars (US$3M) and ferry it in\u00a0 \u2018Rambo style\u2019 to Brazil, why can\u2019t we do same for our health needs in the country? After all, if resources are decentralized internally it will not flout anti-money-laundering laws<\/p>\n CONCLUSION<\/b><\/p>\n Ladies and gentlemen, the NDC government is insensitive to the plight of Ghanaians. The effect of their commissions and omissions is the destruction of all the good social interventions that the NPP government brought to Ghanaians in the 8 years that they were in office: Cocoa Mass Spraying, Youth Employment (christened GYEEDA), School Feeding Programme, Capitation Grant, and now the NHIS are all collapsing.<\/p>\n Yet the NDC government has not been able to add even a single social intervention programme to what they met in office. It is said that \u201cse wo anya birirbi amma w\u2019ase a, yemmo no kronono\u201d, literally, if you cannot offer a gift to your in-law you do not turn around and steal from that in-law. In other words, \u201cif you cannot better the situation, you also do not destroy what you meet\u201d.<\/p>\n For how long should Ghanaians cry before the incompetent, insensitive, irresponsible, and inefficient NDC government listens. Fellow Ghanaians, enough is enough. The blood of Ghanaians who should be living but who have perished because of incompetence and maladministration should arouse in all of us the spirit of patriotism to resist the rule of the people who are oppressing, distressing and perishing Ghanaians.<\/p>\n <\/p>\n Addressed by Hon. William Kwasi Sabi<\/p>\n MP, Dormaa East<\/p>\n By: Benjamin Epton Owusu\/Citifmonline.com\/Ghana
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