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06.08.2005 Health

Mutual Health Insurance Schemes saddled with huge debts


Koforidua, August 6, GNA- A number of Mutual Health Insurance schemes that have been operating for about five months in the Eastern Region are now saddled with heavy debts, a survey conducted by the Eastern Regional Secretariat of the National Health Insurance Schemes (ERSNHIS) has indicated.

The Afram Plains District Health Insurance Scheme that had implemented the scheme for six months has accumulated a total health bill of 996,453,000 cedis with 449,169,000 cedis still yet to be settled.

The Akuapem North District Health Insurance Scheme, which operated for ten months made a total bill of 523,797,214 cedis with 274,414,439 cedis unsettled.

Mr Godfried Boateng Sefa of The ERSNHIS announced the results of the survey at an executive meeting of the Eastern Regional branch of the Network for Mutual Health Organisations of Ghana (GNEMHO) at Koforidua on Friday.

He said the survey indicated that subscribers to the schemes now had easy access to health care and this had increased hospital attendance rates. Mr Sefa said though the survey indicated that some of the service providers were happy about the utilization of their services they was pressure on some of the facilities as a result of the high utilization rate.

He said the survey indicated that the exempted groups were enjoying from the little resources of the paid up members and that there was no control on the utilization of the benefit packages at the facility level.

Mr Sefa said the clients of the scheme were not happy about their being made to purchase drugs sometimes either within or outside the hospital, some referral cases and the attitude of some of the health staff towards them.

He said the survey also indicated that some of the clients were not happy about the time they spend at the facility as compared to the uninsured clients of the service providers. Mr John E. K. Pratt, National President of GNEMHO and a member of the National Health Insurance Council (NHIC), however, gave the assurance that by the middle of this month most of the schemes would receive funds from the National Health Insurance Fund.

He called on the schemes to embark on an exercise to educate their clients on the implication of the abuse of the utilization rate of the health facilities on the schemes and also to support preventive measures to help reduce the rate of hospital attendance.

Mr Pratt also gave the assurance that soon complaints committees would be established in all the districts to settle clients and the service providers' grievances.

The Eastern Regional Director of Health Service, Dr Ebenezer Appiah-Denkyirah urged the scheme managers to raise the complaints that they receive from their clients about the service providers when they meet at the negotiating table.He advised the managers to categorise the people who utilize the facilities.