National health insurance scheme in 2003, through an act of parliament act 650 was established to provide equitable access and financial coverage for basic health care services to Ghanaian citizens. The act established national health insurance authority, with the responsibility of registration of subscribers and paying for services render to these subscribers who remain active with the scheme.
The current challenges that confront the NHIS were predicted right from inception by both local and international actuaries. It warned that by 2008, there will be serious funding challenges confronting the NHIS if the funding processes were not reviewed.
Is the NHIS really covering all the disease conditions we know to be detrimental to the health of the Ghanaian citizens. The status NHIS was to take care of all billing formalities of which an individual finds him or herself. From the spectrum of NHIS act, a number of conditions have been sorted to be taken care of whereas other diseases have been excluded. Malaria, diarrhoea, URT infection, skin diseases, hypertension, diabetes, asthma have been covered to be taken care of. On the other hand is the excluded list which are; optical diseases, heart diseases, stroke, AIDS, and others. Considering the above stated diseases categorized, it is said that group A diseases are the 95% of the diseases considered to be prevalent but what about the 5% case incidences which find themselves to be more expensive reported at the hospital. The NHIS was actually formulated to attend to health financial demands of the citizens of Ghana.
The NHIS continue to depend on the NHIL, 2.5%, SNNIT contribution, premium that average fifteen Ghana cedis and covers only 30% of the active members. The scheme expands money disproportionally to those who do not contribute either directly or indirectly. Less than three fourth of its members do not pay premiums owing to the scheme exemptions and believe that the NHIS is collapsed. Individuals who are exempted from the premium are; children, old aged. The scheme is now therefore under a severe retrogress leading to a background of slowing economy.
Low access to invested infrastructure, nothing is dined when nothing is done. Upon all the measures set in place to formulate the implemented facilities, most especially in the rural areas, why should the government spend huge amount of money to build hospitals in the cities rather than considering the small towns in the rural areas. People often ignore these hospitals and seek for better healthcare facility in the cities. The money used could be equally used to build modern healthcare facilities in rural areas. In line with the NHIS policy being implemented. If more hospitals are not built where should the national health insurance scheme be accessible? I believe the NHIS was set as means for primary healthcare. Why can't the people in rural areas also have access to quality free health care?
All in all, for a developing country, the NHIS is an impressive scheme. If it is to remain viable, only to expand, then there is the need for a better focus to hit the nail into its target.
PHYSICIAN ASSISTANT STUDIES
UNIVERSITY OF CAPE COAST