12 September 2008
editorial
The government has finally resolved that all salaried workers and employers, will with effect from July 2009, be required to make compulsory contributions to the new National Social Health Insurance Scheme.
However, given the mismanagement quagmire that the National Security Fund (NSSF) is wallowing in, workers and employers could have a big reason to wonder if their money in the health insurance will not face a similar fate.
Apparently, each employee in the formal sector will contribute 4 per cent of their gross salary and the employers will top it up another 4 per cent, making a total of 8 per cent.
In principle, the National Social Health Insurance (NSHI) scheme should be a good way to raise funds for health care for workers and their families, which has been used globally to mobilise additional resources to improve the overall health status and risk protection of the population.
However, contrary to the suggestion of the experts who carried out the feasibility study on Uganda's NSHI, the need for the government to address the financial, administrative and political "constraints" that may prevent the smooth running of the NSHI, have never been addressed. "Unless the NSHI is structured to be securely insulated from politics, it could become a means for political corruption and patronage. At the end, the common people pay the higher costs of the [scheme]," the consultants said.
Of course it is now general knowledge that the NSSF is suffering from the same afflictions - political corruption and patronage. The NSHI when it takes off, will generate funds in excess of Shs3 billion per month from Uganda's 400,000 formal sector employees. If adequate controls are not put in place, this kind of money can be a source of temptation even for an angelic regime.
That is why it is shocking that no attempt has been made to put in place a fool-proof system that will ensure that NSHI funds are safe from the voracious hands of this government's officials.
Information available indicates that the NSHI will be headed by an 11-member board whose chairman is appointed by the government. Additionally, many of the board members will be government representatives. To make matters even worse, the NSHI will be headed by a managing director appointed by the Minister of Health!
Unless concrete measures and controls are instituted to ensure that the NSHI will not be a milk cow for the NRM government and its supporters, the resistance by employers, workers and trade unionists could be justified.
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