Ranking Member on Parliament’s Health Committee, Kwabena Mintah Akandoh, has revealed that Ghanaians are losing hope in the National Health Insurance Scheme (NHIS).
Mr Akandoh stated although the scheme has struggled since its inception to meet claims of active members from service providers, recent misapplication of funds collected as levies and SSNIT contributions for other government projects in addition to increases in “non-core activities of the fund” has placed the fund into “medical comatose”. As at the end of March 2022, Mr Akandoh disclosed that service providers were owed over GHS2.5bn due to non-payment of claims filed as far back as July 2021.
“Ghanaians are losing hope in the NHIS contrary to what the Akufo-Addo government wants us to believe. The average use of the scheme or average encounter per member per year has reduced from 2.87 a year in 2016 to 2.75 times a year in 2021 due to several factors including the fact that most private service providers are not prepared to offer services to cardholders. NHIS cards are now reduced to being used for primary or basic services at most health facilities. This is clearly expressed in the average claim per member reducing from GHS97.70 in 2016 to GHS69.02 in 2021. Cardholders have no faith that they will receive good service should they use their cards for secondary or tertiary health services.”
Kwabena Mintah Akandoh
Mr Akandoh revealed that considering the fact that the country is experiencing a “hyperinflationary period, with March inflation year-on-year” reported to have “inched closer to 20%”, it poses questions as to how service providers who are owed as far back as last year are supposed to manage to keep their businesses afloat.
“The total annual claims and subsidies grew with utilization from GHS731.25m in 2013 to GHS1.4bn in 2017 only for same to drop to GHS1.0bn in 2020. Clearly, service providers are opting to treat patients who pay cash or use private health insurance to patients who rely on the NHIA card.”
Kwabena Mintah Akandoh
Speaking at a press conference today, May 10, 2022, the ranking member on Parliament’s Health Committee highlighted that the depreciation of the cedi equally affects most inputs required within the health sector. He recounted that as of March 2022, the cedi had lost 14.6% of its value.
“If the fund owed you GHS100,000 in December 2021 by the close of March (a period of 3 months) you would have lost close to GHS14,600 in dollar terms within two months and yet still praying that your claims are paid. However, tariffs for Health Service Providers have stayed stagnant since 2020 e.g. OPD consultation remains steadfast at GHS19.50…”
Kwabena Mintah Akandoh
Service providers denying NHIS cardholders services
Meanwhile, Mr Akandoh emphasized that reports by the Ghana Statistical Service establish that Consumer Price Inflation Index since January 2020 has changed by some 33%. With this, he noted that tariffs are lagging behind rising inflation and service providers are denying NHIS cardholders services because they cannot sustain their operations at these low rates. Describing the scheme as “gradually becoming a white elephant”, he noted that “low tariffs” has equally led to a situation in which service providers are not ready to offer services to cardholders resulting in significant reduction of claims on the fund “and this is well expressed in the low encounter per active member per year and low average claim per member per year”.
Commenting on the impact of capping on receipts of collections into the funds, he emphasized that the implementation of the Earmarked Funds Capping and Realignment Act of 2017 has led to a situation in which the already “under-funded NHIF” is having to contribute to the consolidated fund to be “utilized at the discretion of the finance minister instead of being used to manage the health needs of Ghanaians”.
The National Health Insurance Scheme, Mr Akandoh noted, is collapsing not because of inadequate funds or inadequate legislation but purely as the result of poor public financial management of the fund.
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