Mr Mahama noted that a committee has been set up to restructure the scheme, a move, he said will make it more efficient.
“The National Health Insurance has made a very positive impact on our health delivery and I am going to make sure as president that that scheme does not collapse under my presidency. It is not collapsing, it is giving more service than it has ever done before, and when we do the restructuring, it will make it even more efficient than it has done in its history,” Mr Mahama said on Radio BAR in the Brong Ahafo Region during his Accounting to the People tour Thursday April 28.
“I have set up a committee to restructure the [National] Health Insurance [Scheme]. When it was started, a study was done that showed that if we do not find new sources of income for the National Health Insurance [Scheme], it will collapse. … I think it was 2009. … Since then, we have not found new sources of financing, but the health insurance is still lingering on,” he added.
Mr Mahama denied claims that government owed the scheme since July 2015.
“Government is up to date with its payment. … Government is supposed to owe the health insurance one-quarter. You need to calculate how much is due them, and, so, you need a quarter to be able to calculate how much is due them before you pay. But now every month, government is releasing what is estimated to be due to [the National] Health Insurance [Scheme]. Then, at the end of the quarter, they calculate to see if there is a shortfall or there is an overpayment. If there is an overpayment, it is deducted from the next quarter, and, so, government is up to date,” the president said.
He said the problem with the scheme was its structure, promising that a committee would deal with that problem.
“It is the structure of the [National] Health Insurance [Scheme] itself, we need to restructure it, and that is why I have set up a committee to look at restructuring the [National] Health Insurance [Scheme].
He said the scheme had expanded over the years since the number of outpatients had risen from 597,000 in 2005 to 26 million in 2014.
“In 2005, total outpatient utilisation of the health insurance was 597,000. …In 2014, outpatient utilisation rose to 29.6 million visits. From 597,000 to 29.6 million visits in 2014, you can see the phenomenal increase in utilisation,” explained the president.
“Apart from that claims payments in 2005 amounted to less than GHS8million, if you want to be precise; about GHS7.6 million for the whole of 2005. In 2014, claims payment amounted to GHS1.07 billion. … So, it should show you the magnitude of the expansion that this health scheme has undergone in this short period. So, what we are doing is, we have [set up] a committee to restructure it, so that we can increase efficiency and eliminate fraud.
“I have asked them to fast-track their computerisation, so that we take away as much human discretion as possible, so that we can cut down fraud.
“We need to expand the capitation system to the whole of the country. They have done the pilot, the pilot has been successful, and, so, if we expand the capitation, it will help to reduce the amount of money that is going out and will make it more efficient.
“It will be easy to audit and make sure that the claims are correct, and, so, that committee is undertaking the restructuring. As I speak, the computerisation is being fast-tracked, they are expanding clinical audits of claims and so on and so forth, and, so, we will be able to make this [National] Health Insurance [Scheme] more efficient to be able to serve people.
“…Ghana, when you take the human development index in terms of health care, has made quite significant advances. If you take the UN Human Development Index, we were second only to Cape Verde in terms of access to health care, in terms of rate of reduction of maternal mortality, child mortality, infant mortality, under-five deaths, and all that. So, the National Health Insurance [Scheme] has made a very positive impact on our health delivery and I am going to make sure as president that that scheme does not collapse under my presidency.
“It is not collapsing; it is giving more service than it has ever done before. And when we do the restructuring, it will make it even more efficient than it has done in its history.”