NHIS collapsing -GMA

THE Ghana Medical Association (GMA) has observed that the National Health Insurance Scheme (NHIS) is collapsing.
It has, therefore, called on President J.E.A. Mills to make a personal intervention to prevent the scheme from imminent collapse.
In a statement issued at the end of its third National Executive Council meeting at Tegbi in Keta, the GMA contended that most facilities owed substantial amounts in medicines and consumables procured on credit, adding that as a result, suppliers were no longer willing to supply on credit.
But the Deputy Director of Corporate Affairs of the NHIA, Mr Eric Ametor-Quarmyne, has denied the GMA’s assertion and claimed that the debt service schedule of the authority was on course.
In its statement, the GMA said the Korle-bu Teaching Hospital, for instance, was owed GH¢2.7 million; the Central Regional Hospital, GH¢694,000; the Eastern Regional Hospital, GH¢1,090,000, with similar examples from elsewhere.
That situation, according to the association, had enormously affected the ability of those facilities to provide quality service for their clients, including shortage of drugs and other essential supplies.
“The NHIA is not seen to be actively dealing with these challenges. Instead, in the recent past, it has taken up the responsibility of micro-managing the facilities and their providers on how to diagnose and institute treatment for their clients,” it averred.
The GMA claimed that the authority had issued a directive that medical assistants in sub-districts should refrain from treating chronic conditions such as diabetes and hypertension.
However, those cases were eventually referred to the district hospitals where they were seen by the same medical assistants who complemented the work of the few doctors in the districts, it said.
The association also accused the schemes of neglecting their responsibility for assisting the facilities in capacity building and technical support, adding that the interest of the patient did not seem to be the foremost consideration of the NHIA.
“Clinical audits by the NHIS are necessary and the GMA has no qualms about auditing facilities. It is important, however, that clinical audits should not be used to cow down facilities that complain about the indebtedness of the schemes to them,” it maintained.
In the light of those challenges, the GMA said, it would focus its annual lecture at the College of Physicians and Surgeons on August 25, 2010 on the way forward for the NHIS.
“The National Executive Council of the GMA, therefore, calls on the President of the nation, the Minister of Health and the NHIA to introduce greater efficiency into the operations of the NHIS administration and take prompt steps to reimburse health facilities owed many months in legitimate claims,” the association urged.
The statement was read by its the GMA President, Dr Emmanuel Adom Winful.
When he was reached for his reaction, Mr Ametor-Quarmyne denied that the NHIS was collapsing.
In an interview with Lucy Adoma Yebaoh in Accra, Mr Amertor-Quarmyne said the arrangement made with the health facilities would always leave some debts unpaid and called on the service providers to exercise restraint.
He explained that the NHIA was using what he termed the fee-for-service method, which meant that the health facilities would provide services for the NHIS subscribers before payments were made.
According to Mr Ametor-Quarmyne, in 2009 alone, GH¢372 million was paid to service providers, adding that NHIA would continue to make payments.