NHIS Technical Committee holds forum in Kumasi

The seven-member technical committee set up by President John Dramani Mahama to review the 11-year-old National Health Insurance Scheme (NHIS) to make it more sustainable, pro-poor and efficient held its maiden forum in Kumasi yesterday.

The Dr Chris Atim committee is also tasked to redesign, reorganise and re-engineer the scheme, create a solid ground for improved delivery in order to facilitate better provisions of services to residents and create a smart scheme based on knowledge and information.

Briefing the nearly 1,000 participants made up of medical doctors, pharmacists, nurses, health facility administrators and some subscribers, Dr Atim, who is a renowned health economist, said as of December 2014 the subscriber base of the scheme was 10.5 million.

He said more than 29 million attendances at healthcare facilities were recorded on the account of the NHIS in 2014.

Dr Atim said currently, 69 per cent of NHIS registered subscribers, including SSNIT contributors and pensioners, persons under 18 years, persons 70 years and above, pregnant women, indigents and persons with mental health conditions, were exempted from paying premiums.

Others were categories of the disabled designated by the ministry responsible for social welfare, as well as beneficiaries of the Livelihood Empowerment Against Poverty (LEAP) programme.

Consequence

He explained that those excused categories accounted for 69 per cent of registered members of the scheme and as a result only an estimated 31 per cent of members paid contributions which were also not at a fixed actuarially determined rates.

Revenues

Dr Atim said revenues from contributions collected over the years formed a relatively small proportion of NHIS inflows, accounting for 3.4 per cent of total revenue in 2014.

He added that the National Health Insurance Levy (NHIL) contributed 73.8 per cent of total revenue, money from SSNIT contributions accounted for 20.4 per cent, adding that from those fragmented pools of funding prior to 2012, the scheme now operated a single pool of funds from which services were procured from providers and administrative and operational expenses paid.

Forum

Most of the people who made presentations called for the establishment of a fund manager similar to the District Assemblies Common Fund (DACF) to receive the levies and contributions and disburse them.

Surprisingly, a large number of service providers confessed that they were into co-payment; the process where patients were asked to pay additional amounts to cater for medicines that were not covered by the NHIS.

A number of participants raised concerns about the quality and efficiency of the drugs being provided to patients and called on the scheme to work to ensure that card holders were given the best of care.