NATIONAL HEALTH INSURANCE SCHEME
WHAT IS THE MAJOR GOVERNMENT POLICY ON HEALTH FINANCING IN GHANA? The Government is to replace the existing ‘Cash and Carry’ health financing system with a National Health Insurance Scheme. WHY? Because the current ‘Cash and Carry’ System, which makes it compulsory for everybody to pay money immediately before and after treatment in our hospitals/clinics etc., is not within the means of most Ghanaians and many are not going to our hospitals and clinics resulting in needless deaths. SO WHAT WILL THE HEALTH INSURANCE DO? The health insurance will allow everybody to make contributions into a fund so that in the event of illness contributors could be supported by the fund to receive affordable healthcare in our health facilities. HOW WILL THIS BE DONE? The Government has already developed a policy framework to provide the general guidelines for the establishment of the National Health Insurance Scheme. A law has been passed to provide the legal framework necessary to facilitate the establishment of the National Health Insurance Scheme. The law makes it compulsory for all Ghanaians to join a health insurance scheme in Ghana. THERE ARE THREE TYPES OF SCHEMES AVAILABLE UNDER THE LAW: • • • The District-Wide Mutual Health Insurance Scheme. The Private Mutual Health Insurance Scheme. The Private Commercial Health Insurance Scheme.
The Government does not want to take chances and has therefore decided to support the District Mutual Health Insurance Scheme concept to ensure that: • • • Opportunity is provided for all Ghanaians to have equal access to the functional structures of Health Insurance. Ghanaians do not move from an unaffordable ‘Cash and carry’ regime to another unaffordable Health Insurance one. A sustainable Health Insurance option is made available to all Ghanaians.
The quality of healthcare provision is not compromised under Health Insurance.
SO HOW WILL THE DISTRICT-WIDE SCHEMES LOOK LIKE? Each district will be divided into Health Insurance Communities so that Health Insurance could be brought to the door step of all Ghanaians. WHAT IS A HEALTH INSURANCE COMMUNITY? It is any group of adults who live in the same geographical areas and coverage to register and vote at specifically pre-determined polling station or stations in the area. A Health Insurance Committee will be formed in each Health Insurance Community to oversee the collection of contributions and supervise its deposit in the District Health Insurance Fund. The Committee Members will comprise of the following: • • • • • The chairman Secretary The Collector Publicity Officer Member
The collector will be collecting contributions from residents in the Health Insurance Community under close supervision of the other members of the committee. To ensure that the contributions of residents are safe and properly accounted for and facilitate access to quality health care by contributors, the Chairman or Secretaries of all Community Health Insurance Committees will come together to form a District Health Insurance Assembly. WHAT WIILL THE HEALTH INSURANCE ASSEMBLY DO? It is the highest decision making body on health insurance in the district and will prepare a constitution to provide general guidelines for the operation of Health Insurance in the district. The Health Insurance assembly will also support a board of trustees which will in turn appoint a management team to handle the day-to-day management and control of the scheme. The management team will comprise: • • • • • The Scheme Manager Accountant Management Information system Manager Claims Manager Publicity and Marketing Manager
Data Entry Operator(s)
The Health Insurance Assembly members, the board of trustees, the community health insurance collectors, and the management team of all Districts-Mutual Insurance Schemes and the health providers will be trained to ensure the efficient management of the schemes in the districts. HOW MUCH WILL ONE PAY AS...
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