27.03.2020 Feature Article

NHIA Must Pay Healthcare Providers Immediately

An Open Letter To Dr. Lydia Dsane-Selby- NHIA CEO
Dr. Lydia Dsane-Selby- NHIA CEODr. Lydia Dsane-Selby- NHIA CEO
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Dear Dr. Lydia Dsane-Selby, this my letter to you is to draw your attention to the current critical times globally so far as the COVID-19 pandemic is concerned and to ask you to make good the NHIA’s indebtedness to the healthcare providers.

Dr. Dsane-Selby, the whole world is battling the infectious COVID-19 and even the rich countries are in difficult times. Ghana is currently bearing its brunt of the pandemic. These are therefore critical times for healthcare providers in Ghana especially the public health facilities that provide health services on credit to National Health Insurance (NHI) clients. Dr. Dsane-Selby, I know you are a Medical Doctor and you were once a frontline health worker so you understand the current critical situation more from the frontline health worker perspective within the context of woefully inadequate healthcare commodities.

Dr. Dsane-Selby, most of the public healthcare providers under the National Health Insurance Scheme (NHIS) and about 75% of the patients these healthcare providers treat are valid NHIS membership cardholders. Again Dr. Dsane-Selby, all the public hospitals and polyclinics provide healthcare to NHI clients with monies from their Internally Generated Funds (IGFs).

Dr. Dsane-Selby, contrariwise to the arrangement of 90 day payment by the NHIA after claim submission by the service providers (the health facilities), your organization (the NHIA) had kept bills in arrears in huge sums. Usually, submitted claims from some hospitals are in arrears for months thereby depriving the hospitals with money to work with it. The NHIA’s indebtedness to the public hospitals even compelled the Ghana Audit Service to query some public hospitals on the grounds that they failed to recover the debts from the NHIA.

NHIA CEO, with this COVID- 19 pandemic on our hands and mindful of the increased consumption of certain health commodities by the hospitals amidst price hikes, it is logically inferable that the hospitals are in dire need of cash to buy commodities. Dr. Dsane-Selby, I noted earlier that you are a qualified Medical Doctor and you were once a frontline clinical staff at the hospital level so you are better placed to understand the plight of a frontline physician who does not have the requisite resources to work with. If you do not understand the plight of frontline clinicians in this regard, then who else should?

Dr. Dsane-Selby, the primary purpose of the National Health Insurance Fund (NHIF) is to pay the healthcare providers promptly. As such, focusing on other areas of expenditure as we had seen in the media last year in terms of certain sponsorships of individuals tend to deplete the NHIF unnecessarily and deviates the Fund from its primary legal purpose.

Madam CEO, your colleague Medical Doctors under the auspices of the Ghana Medical Association (GMA) issued a press release dated 21st February, 2020 and equally called on the government and the NHIA to ensure payment of monies owed by the NHIA to the healthcare providers. In the press release under reference, the GMA said,

  1. It has noted with great concern the failure of the NHIA to pay health facilities (Public and Private Hospitals) for services rendered since March 2019.
  2. As a matter of urgency, government and the NHIA should pay all monies owed these health facilities with immediate effect.

Dr. Dsane-Selby, the GMA was of the considered opinion that your prompt payment of the submitted claims to the hospitals will not compel the managers of these hospitals to initiate cash and carry payment method for services covered under the NHIS. Your guess is right that the reverse will pose another problem for the nation so far as interrupted healthcare delivery is concerned.

Dr. Dsane-Selby, the foregoing depicts the reality on the ground so time to act swiftly to effect payments is now. If for nothing at all Dr. Dsane-Selby, remember your frontline days of clinical practice and listen to the crying voices of your colleagues under the auspices of the GMA. Till then, I hope this letter gets to you and that you will act swiftly on it. Pay the Hospitals now.

~Asante Sana ~
Philip Afeti Korto
Email: [email protected]

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