Persons registered under the National Health Insurance Scheme are now paying more to access basic healthcare.
This comes after the government’s inability to fulfill its obligations to service providers since July 2022, a situation that is crippling the sustenance of the scheme. Some of these persons suffering from various ailments are now resorting to unorthodox means of treatment.
Faana is an Island community in the Ga South Municipality of the Greater Accra Region trapped between the sea and a lagoon. The only way to access, the community is by canoe.
The Residents, mainly fisher folk, with no access to electricity, water, and basic amenities, also lack quality healthcare.
They often risk their lives, sitting in canoes without lifejackets for over an hour to reach the nearest health facility at Bortianor.
22-year-old Christable Ayekple is a resident here. She became severely ill in February this year.
With no canoes operating at night, she waited for several hours before one came her way; enduring severe pains, putting her life on the edge.
At Bortianor Polyclinic, she was referred to Ga south municipal hospital popularly known as AKA-WAY, and later to Korle-Bu teaching hospital.
At Korle-Bu her insurance card was of no use. After treatment, she was detained for days until her parents paid two thousand cedis as the cost of the treatment.
“On February I wasn’t feeling well so they have to take me to a nearby hospital at Bortianor Polyclinic. When we got there, they could not diagnose me so we were transferred to Weija hospital.”
“When I got there, they could not treat me but was given an injection and later given a referral letter to Korle-Bu Teaching Hospital. So when I went there I was admitted for three days but I thought the health Insurance could have covered something but it couldn’t.”
“They were not happy paying the money though they think the health Insurance could have covered that but they ended up paying getting to thousand six Ghana cedis. That was what they paid. I was disappointed because I thought the health Insurance could have covered part of the fee but it did not.”
Christable’s ordeal is similar to that of millions of registered Ghanaians under the NHIS, who are compelled to pay cash for treatment.
56-year-old Julius Dzodzegbe is also a resident of the Island community and has now resorted to unorthodox means for treating his waist pains even though; he is a subscriber of Ghana’s Health Insurance Scheme.
Julius is yet to visit any health facility because he is unable to foot the bills for his treatment.
‘My name is Julius Dzodzegbe; I have been living here for the past 40 years. As I speak to you, I have severe waist pains but my NHIS is of no use now’
His brother Swetor Dzodzegbe has vowed not to renew his NHIS membership, which expired months ago due to difficulties in assessing basic healthcare.
‘I have decided not to renew my membership with NHIS, which expired months ago. My card is currently of no use because I always pay for treatment anytime I visit the health facility’
On Friday, December 9, 2022, CEO of the national health insurance scheme Bernard Oko Boye told President Akufo-Addo at the jubilee house that over one million cedis owed to health facilities have been cleared with an outstanding five-month payment to be made.
He also assured health facilities that the government was working on reaching a clean slate.
‘When we came into office, the arrears where over a year’s payment and over one billion plus. The health Insurance owed some facilities thirteen\fourteen months of arrears. Am happy to say that as we speak, we have paid up to April of this year.”
“Therefore, if you take out April, there are eight months left and the way the scheme runs it will take us about two to three months for claims, submission and vetting. Therefore, we take those ones out to see the real arrears that we have. So is about five months that we owe facilities when we take out the periods for vetting clicks”
The several categories of healthcare facilities accredited by the National Health Insurance Authority to provide services to subscribers are now losing their cool, as they have not been paid their claims for eight months’
According to them, several attempts to have the Ministry of Health and the Authority address their grievances have failed. They have vowed to soon operate a full cash-and-carry system. Frank-Torblu Richard is the General Secretary of the Private Health Facilities Association of Ghana.
‘The health service providers have agreed that ok fine if that is the case, instead of four weeks period; we could manage three months for you so that you will be able to pay within the three months. Then three months turn out to be four months, four months became six months. Now we are hovering around eight months before we receive one-month claims from the National Health Authority.”
“Now when this thing started, we started getting alarmed, so we realized that we became so helpless and decided if that is the case we will go to a place that is called Cool Payment ‘Cash and Carry’ we started it.”
“Any time health care seekers visit our facilities, we make sure that the product is paid so we raise money to meet our obligations along the line and it was working for us. Some facilities are already out of the NHIS that I am very much aware of. They are completely out.”
“When you take your NHIS card to those places, they will tell you to either go or bring cash and we serve you or do not come at all. Is simple as that. There are some that are already getting out and more are likely to get out.”
A report by the Parliamentary Select Committee on Health shows how successive governments have failed to credit the National Health Insurance fund with monies generated from the 2.5% NHIL and the 2.5 percentage point of SSNIT contributions per month.
Sound up – show slides of reports…
A SEND Ghana report last year on citizens’ assessment of social protection delivery in the country also revealed enormous liquidity challenges facing the National Health Insurance Scheme. The Private Health Facilities Association of Ghana says the trend is worrying.
“In 2013, the total amount collected by the government in respect of National Health Scheme Levy amounted to eight hundred and thirty million Ghana cedis and out of that money four hundred and ninety two was released to the National Health Insurance Authority.”
“Then in 2014, they had nine hundred and eighty cedis and seven hundred and thirty one representing 75% to the National Health Authority. Now when you go to 2015, the National Health Insurance Levy reliased one million one hundred and sixty two thousand ghana cedis and out of that eight hundred and fourty six million was given to the National health Insurance.”
“Revenue that is supposed to be used to pay the health service providers continue to come, these are tax revenues because on daily basis if you go to Tema Port, National Health Levy is collected, if you go to ECG is collected, if you go to any shop in this country revenues are collected.
The question therefore is, why is the monies not going to the National Health Insurance Authority for onward transmission to the health care providers in the country. Therefore, we started interrogating them in this issue before we released that, it is the government that is not making the funds available to the National Health Authority.
The Minority in Parliament has said the National Health Insurance Scheme faces imminent collapse due to delays on the part of the government in releasing funds. Kwabena Mintah Akandoh is a ranking member of the Health Committee of Parliament.
‘President is actually collapsing the National Health Insurance. It looks as if the president is not on top of issues. The people who writes his speeches and people who brief him don’t do it well they always subject the President to ridicule.”
“As far as we are concern in this house, in 2023 budget we are going to rein in not less than 5.28 billion Ghana cedis to this in the name of National Health Insurance Scheme. Do you know how much will be given to the National Health Insurance Scheme in the budget for operations; we are going to give them not less than 2.7 million Ghana cedis. Where is the 2.3 or 2.7 million cedis going, where is that money going?”
“Therefore, this are the issues, as I speak to you now National Health Insurance Authority owes Service Providers in excess of three, four, five months. The President does not know so for me I ask myself what kind of briefing his receives at the presidency.”
“Anything he said infact most of the things he said in his speech will respect to health and it seems to me that the man is not on top of issues”
Until the government takes steps to reverse the worrying trend of non-payment of claims to service providers, many subscribers will continue to pay hefty sums for treatment.
Ghana also risks failing to achieve SDG goal 3, which enjoins countries to ensure good health and well-being for all, if ordinary citizens cannot afford basic health care through the national health insurance scheme.
