We need a resilient health insurance system
Health care financing in Ghana began with a tax-funded system that provided free public healthcare services to all after independence.
Advertisement
As that system gradually became financially unsustainable on account of the economic stagnation in the 1970s, low user fees were initially established for hospital services to discourage unnecessary use, locally recover some costs and generate provider performance incentives.
Continuous decline in government spending on health through the 1970s and 1980s led to a shortage of medicines, supplies and subsequently deteriorating quality of care.
Following the adoption of structural adjustment reforms in 1983, the Rawlings administration raised and expanded user fees for public health care services in a system that became known as “cash and carry.”
The user fee system improved operating revenues for some facilities, but it was poorly regulated, inconsistently implemented, and found to have worsened access to care for the poor.
Starting from the early 1990s, Ghana began to seek other ways of financing health care, including non-governmental initiated community-based health insurance schemes (CBHIS). While popular among members and international donors at the time, the schemes were only targeted at specific areas, and as such failed to address key social insurance issues, and were not supported by general government revenue to allow them to cater for the poor.
Subsequently, the National Health Insurance Scheme (NHIS) was established under Act 650 of 2003 by the Government of Ghana to provide a broad range of health care services to Ghanaians through district mutual and private health insurance schemes.
Coming as a consequence of the deleterious effects of user fees, one of the primary goals of the NHIS was to increase affordability and utilisation of drugs and health services in general, and among the poor and most vulnerable population in particular.
The NHIS is, therefore, a social intervention programme aimed at providing financial access to quality health care for residents in Ghana.
Currently, the NHIS Benefit Package is said to cover over 95 per cent of disease conditions affecting residents, and including over 550 formulations on the NHIS medicines list, ensuring comprehensive coverage for all diseases under the scheme.
Today one can say that the NHIS has come a long way as it is working at fulfilling its mandate of providing quality and affordable healthcare to Ghanaians.
The Daily Graphic therefore, deems as welcoming news the publication last Tuesday that the National Health Insurance Authority (NHIA), established under the National Health Insurance Act 2003, Act 650, to attain universal health insurance coverage for all, had transferred GH¢400 million to user facilities to cover claims for April and May of this year.
The report, which also indicated that there were preparations to release an additional GH¢400 million in the coming weeks for the payment of claims to facilities to address outstanding claims from healthcare providers nationwide, is indeed heartwarming as that step enforces the government’s commitment to provide healthcare for the citizenry.
Before this disbursement, the NHIA had earlier in the year released GH¢300 million to cover claims up to January 2024 for various health facilities and also released other amounts to higher and lower-tier healthcare providers, including missions, public, private and quasi-public healthcare providers nationwide.
The Daily Graphic commends the NHIA for the work it is doing.
We commend the current NHIA CEO, for ensuring that the authority demonstrates its commitment to support healthcare providers and ensuring the sustainability of the NHIS, by paying off most of its debts
We also commend the NHIA for taking up some of the dialysis expenses of patients, totalling GH¢1,588,565 under the government’s free dialysis programme since its inception in June, this year, at six health facilities.
We call on the NHIA to keep up the momentum of reimbursing user facilities on time and on schedule, to ensure that they are also able to pay back their creditors.
We also call on the government to ensure that it releases funds promptly to the NHIA so that it can also play its role effectively and efficiently.
We urge the government to do whatever it takes to, at least ensure all the citizenry enjoy Universal Health Coverage by laying a strong foundation for a robust and resilient health insurance system.
Advertisement