Clients urged not to abuse health insurance scheme

Mr. Ignatius Baffour–Awuah, Brong Ahafo Regional Minister on Thursday advised clients of the health insurance scheme to desist from abusing the facility and rather help to sustain it.

The Minister gave the advice at the first annual general meeting of Sunyani Municipal Health Insurance Scheme in Sunyani.

He observed that some clients collect drugs from health providers and give them to unregistered friends and relatives whilst some feign sickness and collect drugs from health facilities on realizing their benefit periods are about to elapse.

Mr. Baffour-Awuah expressed shock that some clients after collecting drugs from the hospital sell them for the bills to be settled by the scheme.

“The sustainability of the scheme should be paramount to all and we should therefore not do things that will collapse the scheme”, he said.

The Minister noted that the scheme had paid a total of 39,947,252,995 cedis (GHC 3,994,725.30) in bills on clients within two years of its establishment to various health providers, with the single highest bill of 14.4 million cedis paid on an individual.

Membership of the scheme also increased from 88,881 in 2005 to 135,000 out of a total population of 207,000, representing 65.2 percent of residents in the municipality, he added.

Mr. Baffour-Awuah also noted that the scheme had brought great relief to its clients, especially the poor and the vulnerable and urged all to register to enjoy its benefits.

He commended the management of the scheme for the wonderful performance in spite of problems with its implementation and encouraged it to work harder to enroll 95 percent of the people in the municipality in the coming year.

Mr. Baffour-Awuah asked the management to ensure that problems such as delays in the issuing of ID cards encountered during the first registration would not be repeated in the next registration to ensure that the confidence people had in the scheme did not wane.

He entreated stakeholders to come out with solutions to the teething problems and to adopt programmes and strategies that would help them ensure the scheme's sustainability.

Mr. Ras Boateng, Chief Executive Secretary of the National Health Insurance Council in a speech read for him stated that the very fast rate of penetration of the scheme in the country was a great challenge to the Council as the regulatory body, the district mutual health insurance schemes and health providers.

He noted that the operators were not only operating under the pressure of more than 400 percent increase in attendance but were finding it difficult to continue to provide care to members as the scheme took longer in paying for previous services rendered because of the huge bills.

Personnel at health facilities have to cope with tedious manual documentation and recording of care given to insured patients in order to make accurate claims, he said, adding that, the government had inaugurated a new 15-member council to oversee the smooth and efficient of the scheme to address the problems.

He stated that the Council was working hard to come out with the much needed conditions of service for staff to avoid corruption within the scheme and poor attitude to work.