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Feature Article of Friday, 24 August 2012

Columnist: Nokobi, Tete

For How Long !!

I listened to Felix Ofosu Kwakye, one of the several government spokespersons and Deputy Minister of Information, James Agyenim Boateng on PeaceFm Kokrokoo program and I was intrigued by their certainty of NHIS enrollment figures! The gentlemen were arguing fervently that, the NHIS has seen a tremendous boost in delivery and access since the NDC took over the administration of the country. Felix Ofosu Kwakye, the more aggressive of the two continually boasted of a current enrolment figure of 22.4 million Ghanaians!! That is 89.6% of the population! I do not know how he got his numbers, but his insistence tickled my fantasy to do a little research on how credible these gentlemen are! I took a closer look at the population census of 2010, and focus especially on the age breakdown; and also on the eligibility criteria by the NHIS for payment of premium. The stated criteria for membership; and to qualify a potential beneficiary in making the monthly or yearly premium is;

“In order to become a member of the NHIS one needs to be registered and issued with a Health Insurance Membership ID Card. One needs to pay the appropriate premium (except those belonging to the exempt group) to benefit from the National Health Insurance Scheme” .The exempt group comprises:

SSNIT Contributors
SSNIT Pensioners
People aged 70 years and above
Children under 18 years
This part of the passage is lifted directly from the NHIS website, www.nhis.gov.gh. SSNIT contributors, i.e. civil servants, teachers and other pay at source, hence they qualified suo moto! SSNIT Pensioners, the aged and under 18 are gratitutious riders on the program. Now, looking at the population as given by the Ghana Statistical Service, Ghana has a juvenile heavy population, a marginal workforce composition and a very small older generation. The attach data gives the population of Ghana as aggregated by ages. Age 0-19 is a whooping 49% of the entire 25m Ghanaians. This group, except the 19 year bracket do not pay NHIS premium! The actual figure is 12,060,387. The age at which one is expected to contribute, 20-70 years, if he/or she is not exempted is 11,430,904 representing 47.5%. Recent reports from the Comptroller-General Department, SSNIT and other government agencies in charge of payroll and taxes revealed that, the number of statutory employees is on the decline and has drifted below 1 million. It goes without saying that, the constant contributors to the program hovers around one million; and the remaining 10 million of the eligible payees are self employed or in private businesses!! The aged, which numbers under a million, 873, 661 are by law exempted from payment and enjoy free medical services. Are the two gentlemen telling Ghanaians that, every child born in Ghana, plus every eligible Ghanaian or a foreign resident in the country has signed for the NHIS and making regular payment? This figure of 22.4 million is not just ridiculous but an insult to the intelligence of Ghanaians!! It is not arithmetically and logically plausible!!! There is no way you can achieve 90% coverage of a voluntary policy!! If even the scourge of Ebola virus was staring at us in the face, you will still have doubting Thomas’s who will not sign on. This kinds of Kwaku Ananse story is not new, a couple of months ago, Ghanaians were told a similar Ali Baba story of a 1.7million jobs, however when a more matured person became the labor minister, he denied any knowledge of this phantom jobs. The questions many Ghanaians should be asking this government is that, for how long will they play on our emotions? This sugar coated statistics are becoming one too many!! Health Insurance, like every recurring expenditure in life operates on the principles of qui pro quo!! I also do not think the scheme operates in cycle like a season, where prospective beneficiaries are enrolled at definite times and places. Services are rendered to persons who pays their premium within the specify duration of the policy. You are kicked soon as your premium is behind or the policy elapses. Hence it will be extraneously difficult to come up with a definite figure since the turnover ratio is always high! The greatest challenge of many Ghanaians to this program has been affordability! Ghanaians have been impoverished so much by the failure of the NDC government to focus on a balance growth of the economy instead of massaging micro economic policies to earn the favor of the Brenton Wood institutions. In many instances, politicians and other benevolent individuals in the society have bought health insurance for several people in their communities or the like. So, assuming this figure of 22.4million enrollee on the NHIS program is true and are paying the premium, there shouldn’t have been a Ghanaian without health care!! That notwithstanding, we must also take a critical look at the average Ghanaian and his or her propensity to insure oneself against unforeseen health risk in the future. Much as I do not intend to deride the conscious awareness of a Ghanaian, it is not uncommon for a Ghanaian to believe in his or her God and deities, and perhaps himself more than to insure against a health risk in the future. The failure of health delivery system is directly link to the rise of herbal merchandise on radio, TV and every available organized forum!! If Sylvester Mensah and Ametor Quayme administration had been able to capture 89.6% of the populace, then my grandmother, Wisi Bi Tei at Shai Hills should not cringe when she falls sick!!. There would be have enough funds in the NHIS confers to cater for every Ghanaian, including even refugees from Somalia. Mills-Mahama-Amissah Arthur government has chosen propaganda and lies as a tool to confound Ghanaians!! It is amazing the way these youthful Ministers and spokespersons churns statistics that are palpable false and yet no one has suffered for that obvious ungentlemanly behaviors’. It is my prayer that, the unseen but graciously glorified heavenly father, who is said to have received our departed President into his inner chambers will incline his favor and mercies upon us the living, for the remaining days of this propaganda laden government!

Table 3: Population
Age Group % No Total Cumulative Total

Total 100.0 24,658,823
Less than 1 3.0 731,201 731,201
1 – 4 10.8 2,674,205
5 – 9 12.7 3,128,952
10 - 14 11.8 2,916,040
15 - 19 10.6 2,609,989
20 – 24 9.4 2,323,491
25 – 29 8.3 2,050,111
30 – 34 6.8 1,678,809
35 – 39 5.8 1,421,403
40 - 44 4.8 1,186,350
45 – 49 3.8 938,098
50 - 54 3.4 833,098
55 – 59 2.1 523,695
60 - 64 1.9 475,849
65 – 69 1.2 293,871
70 – 74 1.4 351,330
75 - 79 0.8 205,953
80 – 84 0.6 159,084
85 - 89 0.3 83,070
90 - 94 0.2 51,081
95 + 0.1 23,143

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