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Opinions of Sunday, 26 August 2012

Columnist: Oppong-Peprah, Edmond

Insensitive NHIA Gets Frustrated Over Capitation

Our attention has been drawn to attempts by some National Executives of the National Health Insurance Authority (NHIA) to suggest that the Asante Development Union (ADU) had contributed to the reduction in the registration figures and renewal rate of the National Health Insurance Scheme in the region. The officials of the NHIA have mounted various media platforms to lay blame of low renewals of the NHIS in the region on the shoulders of the Asante Development Union on the lame excuse that the ADU had persuaded people not to register.
This excuse is so lame that it becomes unpardonable. ADU takes serious exception to such sorry allegations.
The low renewal rates and multiplier effects that threaten the survivability of the National Health Insurance Scheme is self inflicted and can be attributed directly to the implementation of the Capitation Policy.
It will be recalled that the Asante Development Union (ADU) has been making passionate appeals to the National Health Insurance Authority for the suspension of the Capitation Policy in the region since January 2012. It is again on record that ADU has made appeals to government on several occasions, on behalf of the people of the region to suspend the Capitation policy all to no avail.
It is noted that the government has deliberately turned a deaf ear to the calls of the people to suspend the Capitation.
Sadly the effect of the Capitation has caught up with us;
1. There has been a massive declined in O.P.D. attendance.
2. The renewal rate of the card-bearing members has gone down drastically.
3. Patients are now prescribing and buying their own drugs because they cannot afford to go to the hospital.
4. Patients have lost confidence in the scheme.
5. The region has recorded a high percentage of maternal and child deaths.
6. There has been confusion and chaos on the side of both the providers and the patients thereby affecting quality health service delivery.
7. There is co-payment and cash and carry in the system.
8. Komfo Anokye Teaching Hospital is running down due to lack of funds which was recently confirmed by the CEO.
9. Other health facilities are running down under capitation.
Indeed the recent call by the Chief Executive of Komfo Anokye Teachning Hospital to be allowed to charge a higher fee under the National Health Insurance so as to be able to run the hospital efficiently goes to buttress what ADU has been saying all along. Indeed the mid -year report stated that the KATH is seriously constrained as far as health provision is concerned.
If this is happening to KATH then what can be said about other health delivery facilities in the region? What then, will happen, at the private Hospitals?
Clearly the health of the people is in serious jeopardy. There is a complete loss of confidence in the National Health Insurance Scheme, hence people’s refusal to renew their cards.

It therefore come as a surprise that, instead of admitting that the capitation had failed, and to the proper thing, the NHIA and perpetrators of capitation seek to lay the blame at the door steps of ADU. This is very unfortunate.

It will again be recalled that under the policy document that guided the implementation of the capitation, the limitations of the policy captured under the theme “1.5 POTENTIAL CHALLENGES OF CAPITATION “included the following;

• Tendency to under-provide services
• Referral to other providers
• Reduction in diagnostic tests
• Attempt to enroll healthier individuals
It comes therefore as no surprise that the present challenges are being encounter.
One wonders, how could any serious Nation accept these as limitations to a study on its own people? The NHIA should answer the following question:
1. What is the compensation for the trauma, pain, strain, shock, distress; suffering and the death inflicted on the people by this pilot capitation programme?
2. Why should the people in the region suffer the moral hazard of a policy in the name of pilot?
3. Why should people lose lives because of a pilot programme?
4. Is there any means to bring all the lives lost back after the pilot?
5. Should the hard earned businesses of the people of the region collapse because of a pilot programme?
6. Will the collapsed businesses of the Private Providers be restored after the capitation?
7. Are the people in this region some second class citizens of this dear country?


NHIA have purposively inflicted pain and hardship on the good people of the region, depriving and robbing them of their right to health. The NHIA is frustrated because the evidence is clear that it has failed. The NHIA should be humble enough to admit its errors and to suspend the capitation programme. The NHIA should bear in mind that we are all Ghanaians, and posterity will judge them for their actions and inactions.

COORDINATOR ...................................
Edmond Oppong-Peprah