Govt urged to address NHIS challenges

Thursday, November 18, 2010
THE Association of Health Service Administrators of Ghana (AHSAG) has identified some major challenges hampering the implementation of the National Health Insurance Scheme (NHIS) and called on the government to address them as a matter of urgency.
In a communiqué issued at the end of its 34th annual general meeting in Takoradi, the association summed up the challenges as delay in processing and submission of claims, fraudulent practices, poor quality services, inadequate health professionals and inadequacy of essential medical supplies.
To ensure sustenance of the scheme, the association called on the government and other stakeholders to take note of the issues and find solutions to them.
The theme for the event was; “Sustaining the National Health Insurance Scheme: The role of the Health Services Administrators”.
In an eight-point communiqué which was signed by Mr Benard Kwasi Botwe and Mr Micah Asare Bediako, the President and the Deputy General Secretary of AHSAG respectively, the association said information it gathered from the National Health Insurance Authority (NHIA), seemed to suggest that expenditure in recent times had increased and might outstrip the income if pragmatic steps were not taken to reverse the trend.
“For instance, the information shows that in 2005 income for the scheme was higher than expenditure. However, by 2010, expenditure had equalled income and it is projected that by 2012, expenditure may exceed income .
In spite of the challenges, the association noted that the NHIS had chalked up a lot of successes and, therefore, commended the National Health Insurance Authority (NHIA) and the government for the achievement.
Some of the achievement it mentioned were increased in access to health care services by the generality of Ghanaians and specific packages for the poor and the vulnerable as well as increase in the financial resources of health care institutions, among others.
The association , however, noted that the sustainability of the NHIS, like other business venture, depended largely on positioning the scheme on a sound financial footing and recommended that the government, the Ministry of Health, NHIA and other stakeholders sought alternative sources of income for the scheme as measures to fortify its revenue base and sustainability.
The health service administrators declared their support for the Vice President’s pronouncement that a portion of the expected oil and gas revenue would be devoted to the NHID and in addition called on the government to allocate a percentage of revenue from cocoa and royalties from the mines and other extractive industries to support the scheme.
On the reimbursement of insurance claims, the association commended the NHIA for reducing time reimbursement of claims from 90 days to 60 days. It also commended the authority for having fully reimbursed all service providers up to July, 2010, and 50 per cent of the August, 2010 claim.
In spite of the commendation, the association noted that, notwithstanding the positive developments in the implementation of the scheme, there were difficulties in data capturing, compilation of claims, processing and vetting of claims and delays which caused problems with the reimbursement process.
On NHIS tariffs, the AHSAG observed that the operational guidelines governing the introduction of the current tariff regime stipulated that tariffs would be reviewed every six months but it had observed that the guidelines had not been followed since the tariffs were introduced in 2008.
Some issues which when handled effectively could impact positively on the NHIS and were, therefore, discussed at the annual conference were malaria control, staff recruitment and development, construction of new health facilities as well as discipline among health workers.