Feature Article : "The views expressed here are those of the authors and do not necessarily represent or reflect the views of Modernghana.com."

Accra , May 20, GNA - Globalization, which is wheeled by ICT and driven by the International Monetary Fund (IMF) has eased information flow and acquisition of funds. The issue now is the operation of ICT and management of the solicited funds.

To this end, most countries have placed premium on the human resource training and the health needs of their citizens to make them meet the global technological advancement.

Ghana in recognition of this has provided the type of education that would make the graduates think “straight” and also introduced the National Health Insurance Scheme (NHIS) to meet the health needs of the masses.

Most Ghanaians, through intensive public education have bought in to the Health Insurance policy with the result that 65 per cent of the citizenry have been covered by NHIS as at December 2008.

The Health Insurance Scheme has occasioned significant increases in attendance at the out patients departments at the various health facilities, nationwide.

The health status of the masses has invariably improved as most people have adopted prophylaxis/preventive measure as a way of staying healthy as against the curative approach of staying healthy under the previous “Cash and Carry” system as they quickly report to the hospital any symptoms of ill-health.

The Health Insurance, notwithstanding its numerous benefits is currently in management crisis, for non-payment of claims submitted to the National Secretariat of the Scheme.

As at May 2009, the health insurance authority had enough money at the national level. The money was enough to pay for all claims submitted for the next three and half years, even if they did not get any funding for the same period.

It is therefore difficult to comprehend why there is so much complaint from health care providers to the various local schemes for non-payment of outstanding claims for six months.

The ironies are that the Authority at the national level gives the local scheme a specific amount of money to manage for a quarter of the year. Unfortunately what is released does not meet even half of the claims submitted for the same period.

The situation fell into a tailspin in 2008 due to the tripling in claims submitted by health care providers as a result of the authority changing from “pay for service” to the current “diagnostic related grouping” in practice now.

This was worsened by the introduction of free delivery services to pregnant women for which there has been no payment for such services since its inception.

There is therefore a yawning gap between monies given to the schemes and claims submitted.

Additionally, the health insurance drug price list has not been reviewed and there are two effects as a result of non review.

Currently, there are a number of drugs on the health insurance price list, which the cost price is now higher than that on the list as shown by the table below.


LIST OF MEDICINES WITH COST PRICES HIGHER THAT OR EQUAL TO NHIS PRICES

GENERIC NAME, DOSAGE FORM, STRENGTH
COST PRICE
NHIS

Cholera replacement Fluid 5:4:1
1.2/500ml
1.25/500ml

Dextrose infusion 5%
1.05/500ml
1.05/500ml

Diazepam inj 5mg/ml in 2ml
0.23/amp
0.15/amp

Hyoscine Buty Bromide inj 20mg/ml
0.28/amp
0.25/amp

Insulin premixed (30/70) HM, 100units/ml in 10ml
19.5/vial
17.55/vial

Insulin Soluble HM 100units/ml in 10ml
19.5/vial
18.10/vial

Ergometrine inj 0.5mg/ml
0.28/amp
0.25/amp

Gentamichin inj 40mg/ml in 20ml
0.1/vial
0..05/vial

Lidocaine inj 2% in 20ml
1.00/vial
0.76/vial

Nifedipine cap 10mg (slow release)
0.226/cap
0.15/cap

Praziquantel tab 600mg
0.299/tab
0.02/tab

The other scenario is that there is another group of drugs whose price at cost is now very near to the price list.

Another disturbing issue is that the health insurance authority introduced an operationalized ICT platform in 2008 to improve flow of information from the local level to the national level.

The concept is excellent but the Authority acquired a broadband, which has a low speed and incapable of transmitting efficiently information sent by all the schemes to the national level. The scheme platform is used to transmit both claims entries and data entry, which simply put is the sending of information to the national level of those who want health insurance cards and have paid the required premium.

Difficulty in sending such data has led to the inability of the schemes to fulfill their promise of getting any person who pays the premium a card within three months since the cards are all produced at the Headquarters in Accra and its readiness for use is dependent on when the transmitted information gets to Accra . Continued    Source: GNA - Ghana News Agency

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