Health News of Wednesday, 20 June 2012

Source: Daily Graphic

NHIA to start one time premium

The National Health Insurance Authority (NHIA) is ready to implement the one-time premium policy, the Communications Manager at the authority, Dr Nii Annan Adjetey, has said.

According to Dr Adjetey, what the NHIA was waiting for were directives from the government.

He said the government had to determine the date it should start the policy and how much people would have to pay.

Speaking to in an interview in Accra Tuesday, he said the NHIA did not want to contract any figures which would contradict the amount of premium that would be determined by the government.

He said far from being moribund, the National Health Insurance Scheme (NHIS) was undergoing reforms that were driving efficiency and productivity in its operations.

Among some of the reforms, he said, was the introduction of a claims processing centre which had significantly improved claims processing and reduced delays in claims payment to providers.

Dr Adjetey said the introduction of clinical audit to eliminate abuse and improve quality of care, as well as the mass registration exercises that were expanding health insurance coverage of the poor and vulnerable, was part of the reforms.

“The NHIS remains the financial mainstay of the numerous accredited healthcare service providers in the country. It is a source of funding for the procurement of a significant amount of medicines, medical consumables, services, capital projects, logistics and vital equipment for service providers. It accounts for more than 80 per cent of internally generated funds in public health facilities,” he indicated.

He added that study tours by an increasing number of visiting foreign delegations affirmed the rising profile of Ghana’s NHIS as an emerging model for countries in the developing world and beyond.

He said in November 2010, Ghana’s NHIS proudly won the UN award for excellence in such categories as leadership, home-grown initiatives, innovation, scalability of strategies and efficiency and as a hub of shared learning and shared experience in the developing world and beyond.

He asserted that those significant strides were signs of vitality and good health of the NHIS and, therefore, underscored the need not to politicise the NHIS and undermine public confidence in a national institution that all Ghanaians should cherish and support.

Responding to a false statement attributed to the Chief Executive of the NHIA, Mr Sylvester Mensah, claiming that the NHIS was dying a slow death, Dr Adjetey said on June 14, 2012, an interview granted by Mr Mensah was aired as part of the mid-day news on TV3.

He said in the said interview, Mr Mensah had clarified pertinent issues about the NHIS, particularly the proposed one-time premium and the capitation, an additional provider payment mechanism currently being piloted in the Ashanti Region.

According to him, subsequently, a mischievously twisted and distorted version of the news item, authored by Yaw P.K. Manu, was posted on Ghanaweb under the misleading heading, “NHIS is Dying – Mensah”.

He said the statement was calculated to mislead readers and also misinform them about what the chief executive actually said in the TV3 news interview on that day.

Setting the records straight, Dr Adjetey said Mr Mensah never said that the “NHIS was dying”, nor did he say that maternal care and medicines had been withdrawn from the scheme or that plans were far advanced to significantly increase NHIS premium rates from January 2013.

He asserted that the chief executive had not said that with a current annual expenditure of GH¢19 million, the scheme was struggling to stay above water.

“Contrary to Manu’s false claims, medicines are still in the NHIS benefit package and have not been withdrawn. Maternal care services are still free under the NHIS.

“Apart from those gestures, the NHIA also increased the money paid in advance to healthcare providers under capitation and this also means yet more money in the kitty for providers to take care of NHIS patients under capitation.

“The chief executive did not say that the current annual expenditure of the scheme is about GH¢19 million. What he said, and which was clear in the TV3 mid-day news, was that utilisation is not less than 19 million.

Utilisation represents medical encounters or visits by patients. Utilisation is measured by number of visits, not money. It is, therefore, unfortunate that the stated utilisation figure has been monetised and wrongly presented by the writer as annual expenditure,” Dr. Adjetey added.**