Rwanda: Govt Increases Funding for 'Mutuelle De Santé'

The Government will, beginning this fiscal year, implement more subsidies for the community-based health insurance scheme known as mutuelle de santé, which has been grappling with funding challenges.

The extra funding totalling to Rwf10 billion, according to Rwanda Social Security Board (RSSB), has raised the country's prospects of attaining universal health insurance coverage.

It also comes to guarantee the stability of the country's largest insurance scheme, which caters for 88 per cent of Rwanda's 12 million people for their healthcare service needs.

With annual contributions of Rwf32.8 billion, including Government subsidies, and a total spend of Rwf47.4 billion, mutuelle de santé has been facing a funding deficit Rwf14.6 billion every year, according to data from RSSB.

Richard Tusabe, the Director General of RSSB, told a news conference yesterday that the new subsidies are contained in the Prime Minister's Order, which was gazetted last month.

Under the new law, the government will, every year, spend addition Rwf6 billion on mutuelle de santé through direct budget financing.

This is in addition to 100 per cent of the amount collected as penalties for trade of substandard products paid by the public institution in charge of standards as well as 10 per cent of all fees charged on services offered by gaming companies.

Other revenue streams for the insurance scheme include 10 per cent of fees collected from road traffic fines and between 2.5 per cent and 3 per cent of the telecommunication sector's annual turnover.

Tusabe said telecommunication companies alone will be contributing Rwf3.5 billion to the scheme every year.

"The order that was approved will enable us to get at least Rwf10 billion," he disclosed.

However, he said, there is need for more sustainable financing options to cushion the scheme against further budget shortfalls.

"There is a study that is being carried out that will inform us about the available financing alternatives because every year the money that we spend on mutuelle de santé increases as health care services are brought closer to people. The development will allow us to ensure that people continue to get healthcare and medical service providers get paid on time," he said.

Dr. Diane Gashumba, the Minister of Health told The New Times that the subsidies are a response to the increased demand for healthcare services.

"Since community based health insurance was created, sensitisation around early seeking of health services has performed very well and consultations keep increasing in numbers, which is a great thing (that) translated into very positive results: no more severe cases of malaria in Rwanda," Gashumba observed.

However, she said, it is important to note that the Government subsidy was calculated to top up the premium contributed by the community and not to replace it.

"Everyone's contribution has be made timely. We should aim at 100 per cent coverage," Gashumba said, pointing out that such an objective was within the country's reach.

Other subsidies

The government will continue to pay the Rwf2,000 subsidy to the scheme per year for each needy person in category one of Ubudehe.

There will also be 50 per cent of registration fees for pharmaceutical products and medical devices, as well as one 100 per cent of the amount collected as medical research fees paid by the ministry in charge of health.

In addition, the initiative will get 50 per cent of the fees collected for motor vehicle mechanical inspection paid by Rwanda National Police.

If following an audit, the subsidies paid are found less than the amount to be paid, the concerned entity pays the unpaid subsidies and an administrative fine equivalent to two hundred percent (200 per cent) of the amount of the unpaid subsidies, the Prime Minister's order states.

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