A former Health Minister and ranking member on the Parliamentary Sub-Committee on Health, Dr Richard Anane, is advocating for an increase in the National Health Insurance Levy.
His call came at the 2012 Stakeholder Forum, which brought together about 180 stakeholders in the health sector to discuss the issue of sustainability of the NHIS. The forum, which was on the theme, “Re-engineering the financial architecture of the NHIS,” also spent ample time examining the issue of the One Time Premium payment policy.
Dr Anane who was one of the key discussants, made a passionate call for government to consider a 1-1.5% increase in the levy that currently stands at 2.5%. The levy, which directly goes into the National Health Insurance Fund (NHIF) to support the NHIS, has not been increased since the law establishing the NHIS was passed in 2003. Further to his call, he advised that communication of any increase in the levy should be done such that it does not elicit resistance from the public. He opined that the public must be made to understand the essence of the increment. The Nyhiaso MP was categorical, “call it NHIL, let the people know that it is for their health,” and the complaints will be minimal.
According to Dr Anane, he has always advocated for an increase in the NHIL. “When it comes to the NHIS, let us not politicize it and I have always been careful about this,” he stated, maintaining that the NHIS is one of the most useful tools “we have as a people and everything must be done to ensure that it works for our people.”
Other stakeholders were of the view that with the increase in membership and utilization of the scheme, and the high claims submitted by service providers, it is an absolute necessity to diversify the scheme’s means of funding.
About 34% of Ghanaians are active members of the scheme and out-patient utilization has increased from about 9 million in 2008 to close to 25.5 million in 2011. Claims payment to service providers as a result, also increased from 183 million Ghana cedis in 2008 to 549 million Ghana cedis in 2011. Stakeholders argued that despite the increase in the use of the NHIS, its sources of funds have remained the same since inception; a situation they said must be reviewed to give more life to the scheme.
Currently, the scheme is mainly sustained by a 2.5% contribution from the Social Security and National insurance Trust (SSNIT), 2.5% NHIL and budgetary allocation. According to the stakeholders, funds accruing to the scheme from these sources have become inadequate over time and there is the need to increase funding for the NHIS.
Ghana’s NHIS is heavily relied upon by people who constitute the exempt group – pregnant women, indigent, children and the aged – who form about 58 % of the entire active subscriber base of the NHIS. This heavy reliance of such fee-free people on the scheme call for additional injection of funds to ensure the NHIS remains financially buoyant.
On the One Time premium payment, it was agreed that, “given the evidence currently available to stakeholders, it is the considered opinion that the implementation of the one-time premium policy would be ill-advised.” The stakeholders were of the view that the issue of the One Time premium payment be put on hold, as government finds ways to shore up the income base of the scheme.
President John Mahama was at the closing ceremony of the forum. While commending the efforts of management of the scheme, he also stressed the need for frugal management of resources allocated to the NHIS. According to him; “as Ghana begins the journey towards middle-income status, we must endeavor to increase our levels of efficiency drastically, and this starts with prudent management of expenditures such that, services to ordinary citizens are optimized.”
Among participants at the event were hospital administrators, officials at maternity homes, the Pharmacy Council, Economists, the Finance Ministry as well as members of the Parliamentary Sub-committee on Health. Medical practitioners from the private and public sectors were also well represented.
Other notable personalities who took part in December 20-21, 2012 discussions included Hon. Seth Tekper, Deputy Minister of Finance and Economic Planning, Dr Gabriel Buckle of the Catholic Health Association of Ghana (CHAG) and Professor Irene Agyepong of the School of Public Health, University of Ghana. Alban Bagbin, Health Minister, Alhaji Mubarak Muntakar, Chairman of the Parliamentary select committee on health, Kwame Pianim, an Economist and PV Obeng, Chairman of the National Development and Planning Commission (NDPC).