Accra, Nov 22,- The Private
Health Insurance Association of Ghana has called for the amendment of the
National Health Insurance Act 2012(ACT 852) to ensure equitable, affordable and
accessible health care delivery for Ghanaians.
The Association is of the view
that the amendment should require all residents to be a member of a health
insurance scheme of their choice and align the purchase of health insurance
with incomes instead of with complexity of disease.
Mr Ronald Oppong Adom, President
of the Association, made the call in Accra at a symposium on the theme: “The
Role of the Private Health Insurance Industry in Achieving Sustainable
Universal Health Coverage”.
The symposium was supported by
the International Finance Corporation of the World Bank Group.
Mr Adom said the amendment should
limit the cost of health insurance to a value not more than five per cent of
annual pre tax income and ensure equal representation of industry players on
NHIA governance and dispute resolution structures.
According to Mr Adom, the
amendment would create a more sustainable health insurance industry that
optimises revenues available for healthcare and increase transparency in the
build-up of costs along the healthcare supply chain.
Mr Adom said government expansion
of the health scheme to register 40 per cent of the citizenry had exposed a
serious flaw in the scheme’s operational model.
He explained that as a result of
the mismatch between revenue generation and utilisation rates, the scheme
claimed costs had consistently outstripped revenues and it was forecast to
continue to make losses on its current business model.
He said the health insurance had
struggled in large part because the regulatory environment and operating models
of both public and private health insurance schemes were not designed for
sustainability and growth.
“The Association is committed to
dialoguing with government, the NHIA and other stakeholder to improve the
sustainability and performance of the country’s health insurance industry,” he
added.
Madam Esi Nana Sakyi-Ama,
Consultant for the Association, noted that health financing in the country over
the five years had been a mix of tax-based revenues, payment from the Social
Security and National Insurance Trust, grants, member premiums and
out-of-pocket payments.
She said out-of-pocket payments
had increased over the period as funding from government had either declined or
become unreliable, adding that reliable health financing was key to
consolidating advances made to provide financial protection to vulnerable
households.
Mrs Abena Osei Asare, the Deputy
Minister of Finance, said government had paid the health insurance scheme
claims up to April and was working assiduously to clear all arrears to ensure
efficient and reliable health care delivery.
On the Association’s proposed
amendment of the Act, she said government was open for discussions since an
effective health care system delivery cannot be handled by government alone.
Mr Kingsley Aboagye Gyedu, the
Deputy Minister of Health expressed worry about the spate of corruption in the
system, saying about 30 per cent of the claims paid were fictitious and that
government was working on streamlining the system with ICT to curtail the
menace.
GNA
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