THE AMANSIE West Mutual Health Insurance Scheme, which has done 53.89% coverage of the entire district, has paid an amount of GH¢1,405,316.13 to the various Health Care Providers, for about 123,457 insured and active members, since the scheme was implemented in September 2005.
Mr. Oscar Asare Andoh, Scheme Manager, who disclosed this in a status report of the scheme in the district, said as at October 2008 the scheme had issued cards to 67,722 members, representing 89.77% of the total active members, while 12,479 were yet to have their data entered into the system, for the processing of their cards.
Manager Andoh stated that the scheme had, since its inception, collected a total premium of GH¢344,994.41, and that an amount of GH¢56,505 was collected in 2008 alone.
According to him, the highest claim of GH¢964.33, was paid to the Komfo Anokye Teaching Hospital (KATH) in 2008.
The Scheme Manager mentioned some of the challenges facing the scheme in the district, as the existence of other schemes in some institutions, like the Millennium Village Project Free Health Scheme in the cluster of communities, existence of different health care cost, non-availability of providers (Investigation Centers) within the district, non-availability of accredited pharmacy and chemical shops in the district, as well as the slow nature of the new ICT plate form, which is affecting the processing of membership and claims process.
He said since most residents were basically peasant farmers, and therefore within the low income group, they found it difficult to join or renew their membership, once their cards expire.
Other challenges mentioned, were the politicisation of the operations of the scheme, that a change of government may affect operations, and that poor roads in the district sometimes made it very difficult for the scheme to move to the various communities in the district.
Andoh disclosed that the scheme, as part of the National Strategic Plan, intends to increase active membership to 70% of the population by the end of 2009, through the institution of promotional package by which the scheme would reduce the premium to GH¢10 to attract new members into the, scheme and encourage old members to renew their cards, especially those who registered but did not fall sick and therefore did not use their cards at all, to serve as a motivation.
He said the scheme would also introduce institutional and organisational registration, so that the set target can be achieved.
Mr. Andoh said in order not to compromise the quality of healthcare by service providers, the scheme had outlined facility visits, to effectively monitor facilities and assess the quality level of care at first hand.
It also intends to organise a series of stakeholders meetings with Service Providers, Board of Directors, the General Assembly and organised groups, among others, to ensure the development of the scheme in the district.
The scheme also has plans to hold staff meetings monthly, to address management and staff issues.
Meanwhile, the management of the scheme in the district has petitioned the National Health Insurance Authority (NHIA) to consider the inclusion of Buruli Ulcer in the minimum benefit package, since it is one disease which is very prevalent and treated in the district.
This, it was noted, would encourage prospective pharmacists and chemical sellers to register with the NHIA, and establish shops in the district to provide the medical needs of the people.