13 February 2013

Ghana: One-Time Premium Is Possible - Sherry Ayittey

The Minister-designate for Health, Sherry Hanny Ayittey, has given an indication that the one-time premium payment for health insurance promised by the ruling National Democratic Congress (NDC) in its 2008 manifesto would be achievable, when the country broadens its tax base.

"It is possible that we can have onetime premium. We have to look at the mathematics that broadens the tax base. We need to broaden the tax base and get more people in the informal sector to also to pay more tax," she noted.

Currently, it is only the formal sector that the Internal Revenue Service can track easily, since their Social Security and National Insurance Trust (SSNIT) contributions are deducted at source, she said.

To realise the dream of implementing the one-time premium payment for health insurance, Madam Ayittey gave the assurance that she would relate more with the Internal Revenue Service, now operating under the Ghana Revenue Authority, and see how best the tax net of the country could be broadened by bringing the informal sector on board.

She made this observation when she took her turn at the Appointments Committee of Parliament last Friday to answer to questions relating to her newly-assigned role by the President.

Her comments was in sharp contrast to arguments by some stakeholders in the health sector that the introduction of the one-time premium was impossible, since its coming onboard would deplete the coffers of the National Health Insurance Authority, thereby, collapsing the scheme.

The argument further heightened when in 2010, the then Deputy Minister of Health, Rojo Mettle-Nunoo, presented to Parliament an actuarial analysis on the one-time premium payment conducted by the National Health Insurance Authority.

The said analysis revealed that against the backdrop of a medium annual premium of GH¢27.60, a person entering the scheme at the age of eighteen would have to pay a onetime insurance premium of GH₵678, whilst those at the age of thirty years would pay GH₵587.

Similarly, those at the age of fifty years would be required to pay GH₵365, as against GH₵240 for those who have attained the age of sixty years.

It was further revealed that those on levels of the onetime premium to be charged were yet to be fixed. Mr. Mettle-Nunoo, illustrated that "the one-time premium cannot be clearly charged at the present value of all future payments, but rather at a rate that reflects the social and economic conditions of the informal sector workers, who have been presently excluded."

"An actuarially determined onetime premium, based on the current annual premiums, will give rise to amounts beyond the pockets of most Ghanaians," he noted.

A onetime premium payment within the reach of most Ghanaians, the study found, will result in the National Health Insurance Fund reserve getting depleted one year earlier than anticipated, which is 2015.

Outlining some of her main priorities for the health sector when she gets the nod to preside over affairs of the Ministry of Health, Madam Sherry Ayittey said she would ensure the enhancement of access to health facilities in the country.

She mentioned in particular, the construction of more Community-based Health and Planning Service (CHPS) compounds, especially, in rural Ghana, where access to a health center or facility is minimised.

She also assured the Appointments Committee of ensuring financial sustainability of every health service in the country, while also facilitating the training of more medical officers to attend to the health care needs of the citizenry.

That notwithstanding, Madam Ayittey promised to liaise with the Ghana Education Service to help strengthen the health programmes in the various schools in the country, while also liaising with the Christian Council and other charismatic churches to build more health facilities.

"This will help us close the equity gap," she asserted.

Answering a question on whether it was necessary to establish Accident Evacuation Centers along major roads in the country, the Health Minister-designate noted in the affirmative.

According to her, there was the need to have a central trauma center, where victims of accidents would be evacuated to for treatment after receiving first aid in the Accident Evacuation Centers.

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