25 January 2013

Ghana: Rejection of NHIs Cards At Hospitals

The National Health Insurance Scheme (NHIS) was instituted by the John Agyekum Kufour administration about 10 years ago to curtail the gross inequity in access to healthcare delivery by the few rich and the overwhelming majority of Ghanaians, who are poor.

Whereas the rich rush to the hospital at the least excuse, the poor often had to endure unbearable pain for weeks, while they looked for money to pay for transport and pay for investigations and drugs.

For the ruling healthcare philosophy before the Kufour administration, succinctly christened Cash-and-Carry, spared no one, not even accident victims in coma.

The NHIS card changed all that, once the effort was made to pay the premium, all that one needed to access basic healthcare for a whole year is transport to and from the hospital. It almost totally revolutionised access to medicare, recalling for those old enough to remember the good old days of Osagyefo Dr Kwame Nkrumah's free health programme, under which no citizen paid a pesewa for anything health-related.

Thus the NHIS is a commendable programme, and the Kufour administration did very well to introduce it amidst partisan opposition, especially given the fact that the philosophy of the party that formed the government is capitalist oriented, which in most cases often championed the interest of the few against that of the majority.

It is no wonder then that the NHIS has gained in popularity and the number availing themselves of the system has tripled, if not quadrupled. However, there have been reports of several hospitals, including Korle-Bu, reportedly no longer accepting the NHIS cards for the dispensing of much needed drugs, forcing patients to find extra cash to buy medicine from drugstores.

It became a hot issue for the December general elections, with the NPP alleging that the NDC had ran the programme to the ground and the NDC insisting it had increased access to it. For The Chronicle, the issue has now been put in the proper perspective, as to why some hospitals at times shun the NHIS cards.

According to the Acting Medical Director of the Tema Polyclinic, its dispensary has ran out of drugs because the National Health Insurance Authority (NHIA) had been unable to refund to it GH¢300,000 accrued under the NHIS, since September 2012.

Speaking at a 2-day "2012 Annual Performance Review Conference" of the Tema Metropolitan Health Service, Dr William Darko explained the last time the polyclinic received a refund from the NHIA was August 2012.

"The situation has led to the medical stores refusing to supply more medication to the polyclinic and had also resulted only in the writing of prescriptions for patients to buy their own medication from outside the facility (polyclinic)", Dr Darko added, and appealed to the NHIA to make refunds of medical bills promptly to enable hospitals run efficiently.

The Chronicle finds it unfortunate that the NHIS appears to be failing in its duty to ensure that the teeming poor enjoy basic health that they have sacrificed to purchase with money that they really do not have. They are put in double jeopardy when after locking their monies in the NHIS, they are forced to find extra money to buy drugs covered by the NHIS.

The NHIA cannot take credit for boosting volumes and at the same time fail to appreciate the fact that increased access implies higher claims, which need to be cleared timeously. Bills that medical facilities incur under the NHIS should be reimbursed promptly, even if the money has to be squeezed out of stone.

It is a black mark for the NHIA and the ruling government any time a NHIS-registered patient is turned away from an NHIS-affiliated pharmacy or dispensary. The time is coming, and very soon, when such issues would determine who wins or loses an election and not base sentiments of ethnicity or man know man. A stitch in time ...

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