NHIS To Suffer Hiccups?

-Additional Funding Needed

The National Health Insurance Scheme may suffer serious hiccups in the coming years
if additional funding is not provided soon to top-up the present sources of funding
for the scheme. In a media interaction with the Chief Executive of the National
Health Insurance Authority last Monday, he re-iterated the need for additional
funding to shore up the finances of the scheme if it must continue to support the
healthcare needs of people resident in Ghana.

“At a time when both members and providers attest to the positive impact of the
Scheme on their health, services and businesses, there seem to be a sustainability
challenge which must be addressed in the 2011 budget” he said .

Mr. Sylvester Mensah, Chief Executive of the NHIA, said anything less than the
equivalent of a 1% increase in the National Health Insurance Levy(NHIL) would throw
the scheme, providers and members into an era of reduced healthcare financing
services in 2011 and beyond.
Mr. Sylvester Mensah said, “The scheme would be constipated, crippled and eventually
disabled if measures are not taken to provide additional funding”.
Despite the fact that Ghana’s GDP has not grown as much as the growth in NHIS
utilization and growth in medical inflation, the main source of funding for the NHIS
since inception has been 2.5% of VAT sales called the National Health Insurance Levy
(NHIL). As a social protection initiative, about 70% of members – including the poor
and expectant mothers – do not pay premium.
Mr. Sylvester Mensah explained that his administration inherited arrears of about
GH¢ 115 million from 2008. In that same year, 2008, disinvestment of the National
Health Insurance Fund started and has continued to date. Between January 2010 and
September 2010 alone, a total of about GH¢ 146 million has been disinvested. He
added that current investment cover is less than 6 months, beyond which there would
not be enough income to fully cover the over 65% of Ghanaian residents who are
members of the NHIS.
As part of cost containment measures, the NHIA created a clinical audit division
which has so far recovered over GHS 16 million from past payments.
The statistics indicate that in 2005, when membership of the scheme was only 1.3
million, the NHIS was paying approximately GHS 20,000 per day as claims. Today, with
over 15.5 million registered members and 95% of diseases covered, the scheme is
paying close to GHS 1 million per day as claims. Between 2008 and 2009 alone,
utilization increased astronomically by 75% from 10 million visits to over 17.5
million visits.