THERE is no doubt that the National Health Insurance Scheme (NHIS) is contributing immensely to healthcare delivery in the country. Currently about 12 million people who have signed onto the scheme are reaping the benefits.
However, pressures that have been brought to bear on the scheme require that certain aspects of the innovation should be examined to make it more sustainable and beneficial to the people.
Reports that there is a high rate of intrusion by Fulani nomads and other nationals from some neighbouring West African countries into the scheme are worrying and deserve attention and immediate intervention.
The challenge confronting the scheme now stems from the policy framework that establishes the parameters for the operation of the scheme, as well as the eligibility criteria.
According to the National Health Policy Framework for Ghana (August 2004), “it is compulsory for every person living in Ghana to belong to a health insurance scheme type”. The policy further states that “Every person living in Ghana shall contribute according to the principle of ability to pay in order to enjoy a package of health services covering over 95 per cent of diseases afflicting Ghanaians.”
The fact that the policy guideline does not state whether the scheme is limited to only Ghanaians or that foreigners living in Ghana must have resident status or permit to be eligible for the scheme is the grey area that is being exploited by some of our West African neighbours.
Currently the scheme is funded by premiums paid by the policy holders, 2.5 per cent VAT levy on selected goods and services and 2.5 per cent of SSNIT contributions of workers.
Once the person living in Ghana irrespective of his or her residential status undertakes the health insurance policy under the scheme, there is a contractual obligation on the part of the NHIS to roll out the scheme to his or her benefit. The consequence of such blanket coverage is that we might not be able to sustain the scheme.
After almost four years of operating the scheme, there is the need to review its management and operation, as well as the policy framework, to guarantee its success and financial sustainability.
Fortunately, during the presentation of the 2009 budget, the Minister of Finance and Economic Planning, Dr Kwabena Duffuor, reiterated the commitment of the government to have a second look at the scheme.
The DAILY GRAPHIC commends the government for its commitment not only to maintain the scheme but to make it more beneficial to the people. We believe that we can enhance the operational capacity of the scheme if other problems such as non-conformity to standard treatment protocols with wide varying cost, inadequate and skewed distribution of health professionals, and delays in the transfers of funds are addressed and the deficiencies inherent in the policy framework removed.
We believe that the critical issue that should be considered by the authorities is the question of illegal migrants. It may be a step in the right direction for the government to continue with the implementation of the issuance of national identity cards, since it holds the key to resolving the question of who is a Ghanaian or resident or an illegal migrant.
The NHIS has great potential to enhance the health service delivery system and, therefore, everything should be done to make the scheme sustainable.
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