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NHIS urgently needs review of generous exemptions – Sylvester Mensah|5/5/2015

The Chief Executive of the National Health Insurance Scheme says the exemptions under the scheme are so generous they are threatening its sustainability.


Mr. Sylvester Mensah says the scheme has worked perfectly well but stressed it is time for reforms.


He was speaking on Joy FM’s Super Morning Show Tuesday on threats by the Society of Private Medical and Dental Practitioners to withdraw their services to NHIS card holders.


All children under 18 whose parents have signed onto the scheme, are eligible to free health care. This category of beneficiaries, Mr. Mensah said, constitutes about 40 percent of people who access healthcare through the NHIS.


Elderly persons who are above 70-years are also exempt from paying premiums and so also are SSNIT contributors.


Maternal health care is free under the NHIS completing the avalanche of free services.

Accessing health care services by all these categories of people who do not pay premiums puts a strain on the Scheme, Mr. Mensah said.

“We have got to a new phase where we need to re-examine the strategic tension between what is and what ought to be,” he stated.


He said the NHIS had advised other countries coming to learn from Ghana’s experience that “Given the opportunity to re-establish a health insurance scheme in Ghana, we wouldn’t have the kind of benefit package that we have; it is too generous and our prescription is that, start with a very modest benefit package and grow the benefit package as fiscal space allows.”

Deputy Health Minister, Dr. Victor Bampoe, who was also on the morning show, agreed largely Mr. Mensah about the unsustainable generosity of the benefit package of the NHIS.

“Because it is a social intervention scheme, there is a tension between our best intentions and what we can pay for. Ghana has a health insurance scheme which is exceedingly generous; 95 percent of all disease conditions is covered,” he said.

Dr. Bampoe said whilst government wants the best, “it can always pay for it.”

He said as a medical doctor himself, he appreciates the frustrations of service providers when claims are not paid on time but stressed the situation obtains because there is a yawning gap between the amount of money collected through levies and premiums and the amount of money spent monthly to deliver healthcare services to citizens.

He said whilst government finds the money to enable the Scheme pay its service providers, the internal mechanisms put in place to enhance efficiency of the systems at the National Helth Insurance Authority, the administrative body of the NHIS, must be fast-tracked.

He praised Mr. Sylvester Mensah for introducing innovations designed to improve the operations of the scheme and cut back on waste.  

- See more at: http://www.myjoyonline.com/news/2015/May-5th/nhis-urgently-needs-review-of-generous-exemptions-sylvester-mensah.php#sthash.L1HHGPHa.dpuf
Deputy Health Minister, Dr. Victor Bampoe, who was also on the morning show, agreed largely Mr. Mensah about the unsustainable generosity of the benefit package of the NHIS.

“Because it is a social intervention scheme, there is a tension between our best intentions and what we can pay for. Ghana has a health insurance scheme which is exceedingly generous; 95 percent of all disease conditions is covered,” he said.


Dr. Bampoe said whilst government wants the best, “it can always pay for it.”


He said as a medical doctor himself, he appreciates the frustrations of service providers when claims are not paid on time but stressed the situation obtains because there is a yawning gap between the amount of money collected through levies and premiums and the amount of money spent monthly to deliver healthcare services to citizens.


He said whilst government finds the money to enable the Scheme pay its service providers, the internal mechanisms put in place to enhance efficiency of the systems at the National Helth Insurance Authority, the administrative body of the NHIS, must be fast-tracked.


He praised Mr. Sylvester Mensah for introducing innovations designed to improve the operations of the scheme and cut back on waste. 


Deputy Health Minister, Dr. Victor Bampoe, who was also on the morning show, agreed largely Mr. Mensah about the unsustainable generosity of the benefit package of the NHIS.

“Because it is a social intervention scheme, there is a tension between our best intentions and what we can pay for. Ghana has a health insurance scheme which is exceedingly generous; 95 percent of all disease conditions is covered,” he said.

Dr. Bampoe said whilst government wants the best, “it can always pay for it.”

He said as a medical doctor himself, he appreciates the frustrations of service providers when claims are not paid on time but stressed the situation obtains because there is a yawning gap between the amount of money collected through levies and premiums and the amount of money spent monthly to deliver healthcare services to citizens.

He said whilst government finds the money to enable the Scheme pay its service providers, the internal mechanisms put in place to enhance efficiency of the systems at the National Helth Insurance Authority, the administrative body of the NHIS, must be fast-tracked.

He praised Mr. Sylvester Mensah for introducing innovations designed to improve the operations of the scheme and cut back on waste.  

- See more at: http://www.myjoyonline.com/news/2015/May-5th/nhis-urgently-needs-review-of-generous-exemptions-sylvester-mensah.php#sthash.L1HHGPHa.dpuf
source - myjoyonline.com


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