NHIA in danger if......

Frontpage March 4,2010
Story: Emmanuel Adu-Gyamerah
RESERVES for the sustenance of the National Health Insurance Scheme (NHIS) could be depleted by 2016 without the introduction of the one-time premium payment, the Ministry of Health has indicated.
According to the Deputy Minister of Health, Mr Rojo Mettle-Nunoo, an actuarial analysis indicated that the NHIS, in its present structure, would experience a negative balance this year when the expenditure is expected to exceed revenue.
The study is one of five which have been conducted to inform the government about the way forward for the implementation of the one-time premium payment by beneficiaries of the NHIS.
He explained, however, that “an actuarially determined premium, based on current annual premiums, will give rise to amounts beyond the pockets of most Ghanaians”, adding that the study found that a one-time premium within the reach of most Ghanaians would result in the NHIF reserves getting depleted in 2015.
Further to that, the NHIS reserves would be completely used up in subsequent years and get depleted by 2016.
However, speaking to Joy FM yesterday evening to explain the position of the government on the one-time premium payment, the Minister of Health, Dr Benjamin Kunbuor, stated that the government was still committed to the one-payment policy.
He said the position presented to Parliament on behalf of the ministry by his deputy was one of five scenarios being looked at by the government and that no position had been taken on the issue yet.
He said the scenario presented to Parliament by his deputy was an actuarial study conducted by the National Health Insurance Authority and that the authority was concerned about management and administrative issues, adding that policy matters were the preserve of Cabinet.
He said the position presented by his deputy that gave the impression that the one-time premium payment would be beyond the reach of many people was misleading and that the policy was doable and the government was committed to it.
Dr Kunbuor added that the government would apologise to Parliament.
Speaking on the issue on the floor of Parliament, Mr Mettle-Nunoo said in order to avoid a situation where the NHIS reserves would be depleted, the ministry was exploring other sources of funding to further build up the National Health Insurance Fund reserves and make the NHIS sustainable, even after the introduction of the one-time premium payment as proposed by the government.
On the one-time premium itself, he said a study had indicated that beneficiaries entering the scheme at 18 were to pay GH¢618, while those who would enter at 30 would have to pay GH¢587.
Similarly, those entering the scheme at 50 would pay GH¢355, while those who would enter it at 60 would pay GH¢214.
Mr Mettle-Nunoo added that due to the prevailing economic situation, especially in the informal sector, the study also considered the payment of a GH¢50 flat rate, irrespective of age, for those in the informal sector, should the medium annual premium scenario be accepted.
According to the deputy minister, who announced this in Parliament yesterday, such new sources of funds for the scheme would be proposed to the government by the ministry before submission to Parliament for consideration.
He was answering a question posed by the Member of Parliament (MP) for Sunyani East, Mr Kwasi Ameyaw-Cheremeh, who wanted to know whether the actuarial analysis relating to the one-time payment for the NHIS had been done.
Answering the question, Mr Mettle-Nunoo said the analysis, which had been concluded, considered the inclusion of both the military and the Police Service in the NHIS.
The deputy minister stated that an actuarially determined premium, based on current annual premiums, would give rise to amounts beyond the pockets of most Ghanaians, explaining that the study found that a one-time premium within the reach of most Ghanaians would result in the NHIF reserves getting depleted in 2015.
Pressed further by the questioner, Mr Mettle-Nunoo explained that the said analysis, which is only one of the five studies shown, showed that based on a medium annual premium of GH¢27.60 scenario, Ghanaians were expected to pay the listed premiums under the one-time premium policy of the NHIS, even though the levels of premiums had not been fixed.
He said the ministry was, therefore, undertaking reform programmes to pave the way for the implementation of the one-time premium payment for the NHIS, explaining that the programme would ensure improvement in the use of standard treatment guidelines and rational prescription by service providers to reduce the cost of treatment.
Mr Mettle-Nunoo added that the reform programme would also ensure the improvement of a logistic management system in the sector to bring down cost of inputs such as medicines and consumable.
Another area which would be improved was the claims management process to reduce connivance and wastage, while the scheme would also undertake legal review to improve efficiency and reduce cost, he added.
Answering another question, the deputy minister told the House that the Ministry of Health had procured enough motorcycles for all health facilities in the Brong Ahafo Region, including Community Health Improvement Programme (CHIP) centres.
He said in answer to a question posed by the MP for Asunafo South, Mr George Yaw Boakye, that CHIP centres at New Sawreso and Noberkaw in the Asunafo South District would benefit from the package to make them functional.
In an answer to another question posed by Mr Joe Appiah, the MP for Ablekuma North, Mr Mettle-Nunoo said the Accra Metropolitan Health Directorate had acquired a parcel of land in the Ablekuma North Constituency for the construction of a polyclinic to serve the people in that area.
He said that land belonged to the defunct Ghana National Trading Corporation (GNTC) and explained that the ministry was currently looking for funding to undertake the project.