NHIS Boss Sells Scheme’s Successes & Failures Abroad


Ghana’s growing and leading Health Insurance model, was once again a case study and subject of discussion at an International forum on Universal Health Coverage (UHC) organized in Seoul, South Korea.

Under the theme “Coverage Expansion of Informal Sector: The Missing Middle”, the conference sought to better understand the current status and challenges the world faces in the path to achieving UHC, by sharing the experiences of various countries, including Ghana, Thailand, South Korea, Japan, Mongolia, and Philippine, among others, that have developed unique approaches for UHC.

Speaking on Monday in Seoul on the topic, “Role of National Health Insurance for UHC”, the Chief Executive of the Ghana National Health Insurance Authority (NHIA), Sylvester Mensah, said the scheme has become a victim of its own success.

He illustrated how a rapid growth in active membership and utilization, coupled with a generous benefits package plagued by pervasiveness of moral hazards are threatening the financial sustainability of the scheme in the immediate to medium term.

The NHIS boss, is in Seoul at the invitation of the President of the Korea Foundation for International Healthcare (KOFIH).

He gave a vivid account of Ghana’s health insurance, trajectory over the years, highlighting amongst others, adaptable lessons from Ghana’s experience which include bi-partisan political commitment, innovative financing model and effective stakeholder dialogue.

He cautioned countries at the infant stages of such social protection schemes to grow gradually, adding that strengthening health systems and identifying sustainable sources of revenue are essential pre-disposing factors to success.

He maintained that given another opportunity to establish a National Health Insurance Scheme he would at the outset advocate for a relatively modest benefit package, instant issuance of ID cards based on biometric data, and capitation as the primary provider payment method, among others.

Mr Mensah, described how Ghana has succeeded in reducing out-of-pocket payments through enrolment in the health insurance scheme. He mentioned that recording significant growth in core indicators alone is not enough, as sustaining it could even be more challenging.

Currently, the NHIS contributes over 85% of internally-generated funds of many healthcare facilities in Ghana and delays in payment may suppose that providers are pre-financing health care delivery, with the inherent challenge of abuse and poor healthcare delivery

The conference brought together experts and policy makers from various countries throughout the world to deliberate on the WHO post 2015 agenda of global health coverage issues with universal financial risk protection in sharp focus. The World Bank, WHO, health policy experts, academia, health insurance technocrats and health policy makers from over 20 countries were in attendance.

On Tuesday June 10, 2014, under the auspices of KOFIH, the Ghana- South Korea collaboration for knowledge and experience sharing was extended to a tripartite arrangement with the inclusion of Ethiopia.

KOFIH is a specialized organization under the Ministry of Health and Welfare of the Republic of Korea which was established to promote international cooperation and provide assistance in the health sector for developing countries.

The dialogue session which is ongoing ends today; Friday June 13, 2014.

Source: NHIA

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