The National Health Insurance Scheme – To be or not to be? An open letter to The President of the Republic of Ghana

By K. Ofosu-Barko, FGCP
Your Excellency,

I bring you greetings and extend a warm and hearty congratulations to you on your election to the highest office of our beloved country. I join my fellow Ghanaians to wish you the best of luck in the execution of your duties. Mr. President may I respectfully state at the outset that the only credential with which I write to you is, as Ghanaian. I therefore do not wish for the issue I raise to be trivialised by the unfortunate politicisation and polarization of our dear society along ideological lines. It is my hope therefore, Mr. President that you will see the issue I raise through the same prism that I do.

It is with a heavy heart that I share my thoughts on the state of the National Health Scheme with you. At 07:06 hours on Friday February 15, 2013 I was part of a group that arrived at a hospital on an assignment. In the course of arranging to meet with the Hospital administration, we passed through the Out Patient Department (OPD) several times. On one of these pass throughs I witness a heart breaking scene. An elderly man in his late seventies, perhaps early eighties (shall we call him Opanyin Kwame) arrived at the registration desk in obvious pain to seek health care. He presented his VALID National Health Insurance Card to the gentleman at the registration desk and was told that the hospital no longer accepted the Card. Opanyin Kwame thanked the attendant, took back his Card, reached out for the hand of a young lady, who probably is his granddaughter, and staggered way with an expression of pain on his face.

This situation is the result of National Health Insurance Authority’s (NHIA) inability to reimburse health facilities for services rendered, in some cases since August 2012. This hospital therefore decided, that in order for the institution not to go bankrupt, it would suspend the National Insurance and revert to the Cash-and-Carry state. This hospital’s decision not to accept the insurance card anymore on account of non-reimbursement for services is the result of your government’s inability or unwillingness to release funds for this purpose. This, Mr. President is a travesty to say the least. Mr. President, my information is that NHIA reimburses the health facilities with funds from the consolidated funds, the same funds from which this nation witnessed an unprecedented speed with which judgement debts were paid in our recent history.

Mr. President, this nation was built with the toil and sweat of people like Opanyin Kwame. My generation, and those immediately after mine, including your cohorts, Mr. President, had free education because of the sweat of the likes of Opanyin Kwame. Is this how our beloved country under your administration repays Opanyin Kwame’s generation in the twilight of their days?

Mr. President, permit me to state a premise which I hope you will agree with, and it is that “NO WOMAN SHOULD PAY THE ULTIMATE PRICE FOR GIVING LIFE.” Yet this is what is happing now across the length and breadth of the country under your leadership, and that of previous administrations. The “Free Maternal Health Care Initiative” which was instituted to increase skilled attendants at birth and thereby reduce maternal death is under threat at the facility in question and others like it. Is this supposed to be part of the “Better Ghana

Agenda?” Is this the better Ghana you promised Opanyin Kwame, and our mothers Mr. President?

My information is that for five months as of the time of this letter, health providers, both public and private have not been reimbursed for services rendered, for which the National Health Insurance Authority has a contractual obligation to honour. This has been corroborated by both providers and NHIA. This is the result of your administration inability or unwillingness to release money from the consolidated fund to meet this obligation. This in turn has resulted in the cost of business as supplies raise their prices to compensate for delayed payment. What is your response to this Mr. President?

Fellow physicians, where are our voices in all this? We witness this state of non-payment for services we render on a daily basis. Are we content just because our salaries get paid at the end of the month? What do we have to tell Opanyin Kwame whose toil and sweat paid for our education? Mr. CEO of the National Health Insurance Authority, what do you and your AUTHORITY have to tell Ghanaians? Are you happy with the state of affairs or is it that you are also happy to have your pay check at the end of the month?

Mr. President, you have told the nation that you are decisive. Will you order the release of funds to reimburse health facilities for services rendered or shall we continue to see the likes of Opanyin Kwame languish in pain and pregnant mothers resort to delivery by Traditional Birth Attendants and in the process loose their lives? As one of my teachers told me, “for the child who loses his only mother, it is a 100% mortality!”

Mr. President, your hour of decision is here. How decisive are you?

God Bless our Homeland Ghana

Dr. K. Ofosu-Barko is on the Faculty of Public Health of the Ghana College of Physicians and Surgeons. He is a Public Health Specialist and Foundation Fellow of the Ghana College of Physicians and Surgeons with 36 years of experience in the management of health care delivery systems at the national, regional and international levels.

Posted by on Mar 24 2013. Filed under African News, Features. You can follow any responses to this entry through the RSS 2.0. You can leave a response or trackback to this entry

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