NHIS Could Collapse By January 2015

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Stakeholders Alarmed

Stakeholders of the National Health insurance Scheme (NHIS), have released a damning verdict on the scheme, saying it risks collapse by January 2015 if additional funding is not sourced by government.

The participants in a communiqué, also described as unsustainable the scheme’s current financing arrangement and called for a significant budgetary allocation for the 2015 fiscal year.

They also want government to consider assigning at least 25 per cent of the Communications Service Tax to the NHIA.

The stakeholder’s request follows an earlier accusation by the Minority in Parliament that the NHIS has virtually collapsed under the governing National Democratic Congress (NDC) administration.

There are others, who have also argued that the Members of Parliament (MPs), should stop collecting huge sums annually from the NHIA for monitoring and evaluation of the National Health Insurance projects in the various Constituencies, so that these monies would be invested into the operations of the scheme.

They said that the government was starving the scheme of the necessary funds to effectively provide healthcare for its subscribers.

But government has rejected the claims.

Acting Director of Corporate Affairs at the Authority, Dr. Nii Anang Adjetey, told Citi News that these recommendations are to help revamp the scheme which was currently in dire need of money.

The Christian Health Association Ghana (CHAG), also in July 2014 turned away NHIS card bearers from their facilities, because the scheme owed them about 50 million cedis.

The Ghana Chamber of Pharmacy also threatened to stop supplying drugs to health insurance service providers, because of indebtedness.

Dr. Adjetey insisted that “the consistent refrain on this matter has been that the NHIS needs more money. The scheme has expanded and there was the need for additional income and we’ve made this appeal time and time again so at the stakeholder’s conference it became obvious that the scheme needed more money.

“It’s more than ten years now, the obvious thing is that somehow additional funding must be found for the National Health Insurance scheme,” he added.

The stakeholders also called for the benefit package for subscribers to be reviewed to ensure the sustainability of the scheme.

Meanwhile, the Ghana Medical Association (GMA) has urged government to halt attempts to roll out the capitation mode of paying NHIS claims in the country because the system being piloted in the Ashanti Region has failed.

Below is the communiqué issued from the forum;

Communiqué
Participants at a 2-day NHIS Stakeholder Dialogue held on the 23rd and 24th of October, 2014 at the La Palm Royal Beach Hotel in Accra have maintained that the current cost structure of the NHIS is unsustainable. They observed that the high and increasing funding gap as evidenced by the income and expenditure trend over the past five years call for a fundamental structural review.

1. They consequently called for dispassionate, critical and bipartisan review of the NHIS benefit package using evidence-based strategies consistent with international best practice. They further observed that epidemiological and demographic changes over the past 10 years demand a rationalization of the benefit package for equity and value for money. The forum noted that to match resource availability to the benefit package, the NHIS must provide for what it can fund without denying the poor and vulnerable financial access to health care. The forum also suggested that an effective monitoring and evaluation framework be factored into the design process of any subsequent benefits package.

2. The forum further tasked the MoH and the NHIA to consider a post 2015 review of the broad NHIS exemption regime for all under 18 years of age, all 70 year olds and above, all pregnant women and all SSNIT contributors for the purpose of equity, efficiency and sustainability of the scheme.

3. Stakeholders also recommended the setting up of a technical stakeholder group under the leadership of the MoH to undertake a comprehensive cost assessment of health care delivery using the Health Technology Assessment (HTA) approach to provide a more efficient and realistic NHIS tariff and medicine-pricing regime based on evidence.

4. Among other things, the NHIA was advised to consider engaging more clinicians to add value to its operations and refocus on the poor and vulnerable. The forum also called for the Intensification of clinical audits and other efficiency measures in the immediate term as well as consideration for co-payment in the medium to long-term.

5. The Ministries of Finance and Health were urged to continue to provide leadership and encourage broad stakeholder engagements like this and subsequently implement recommendations that may arise from such fora.

6. The forum called for an increase in the NHIL or significant budgetary allocation for the 2015 fiscal year or both if the Scheme is to survive the first quarter of 2015. The forum recommended, among other things, that government considers assigning at least 25% of the Communications Service Tax to the NHIA.

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