The case for a national health insurance scheme

By Katherine Nabuzale

This year World Health Organisation marked its 70th anniversary by calling on world leaders to live up to the pledges they made when they agreed on the Sustainable Development Goals in 2015, and commit to concrete steps to advance health for all, which means ensuring that everyone, everywhere can access essential quality health services without facing financial hardship.

This raises the potent question of how Uganda is fairing on this agenda of advancing health for all.

There are and have been epochal achievements in the health sector with the latest being a world class women's hospital in Mulago. However, we can't confidently talk of equal access to health services for all when most of the population is unable to meet their hospital bills. For instance, with the high cost of services at the new women's hospital, one can't help but ponder on the fate of the poor women and mothers of this nation.

Every country's development depends on a healthy, strong and vibrates human resource. When the people's health needs are guaranteed and secured, there is maximum productivity which results into, remarkable economic growth. A national health insurance scheme where every citizen is covered is the best step in striking equity and fairness in the health sector. Contributions into the national health insurance coverage can be done in different ways.

For example, in a single-payer system of national health insurance, the government heavily subsidizes health care by substantially raising taxes on the nation. And then there is the mixed health care system, where there are both public and private health insurance plans. Those who are too poor to afford health insurance can benefit from the public option which is from taxes while those with the ability can purchase private health insurance to meet their health needs.

A recent research commissioned by the insurance institute of Uganda and conducted by Makerere university professor Robert Baraza found that only 5% of Ugandans take up health insurance. The down side to this low contribution percentage is owed to the delays in expediting the national health insurance scheme, the absence of which has sidelined many people from accessing health services and timely medical attention.

The development of Uganda will depend on a robust and healthy human resource ready to execute development projects less encumbered with health related problems.

Below are some of the advantages of a compulsory and national health insurance scheme.

Increased access to health and medical services: There are many people who are in need of health and medical services but are hindered by the cost that they must incur on their side. With universal health insurance coverage, many will be encouraged to seek these services.

Risk Pooling: National health insurance coverage is a way of sharing health risks collectively, in a resource pool, thereby minimizing the burden upon individual citizens especially in health incidences where medical costs would far outstrip the financial capacity of an individual or his/her family. Thus, without a national health insurance plan, the people that need health insurance the most have the greatest difficulty finding affordable care. By everyone contributing to a national health insurance pool based on their income, the insurance pool bears less financial risk per individual, which makes it more affordable for those that need it most.

Higher Quality of Life: According to the Economist Intelligence Unit's Quality-of-Life Index, countries with national health insurance schemes have higher life expectancies and are rated as having a higher quality of health care overall. This is because the average person has access to regular visits to quality doctors and timely, affordable prescription of drugs.

Prevention: One of the most significant advantages of having health insurance is the ability to prevent diseases through early detection and doctor recommended lifestyle changes. This prevention not only keeps citizens healthier, but it also saves money on the expense of the health care that would otherwise be required to deal with the problem when it arises.

Those without insurance do not usually have the money to spend on regular preventative visits to the doctor when there is no apparent problem. Which may result in more sickness for uninsured people who may not afford increased health care costs.

Peace of mind: Insured patients don't have to worry about regular precautionary medical examination because they are confident that they would receive timely diagnosis and proper treatment in any eventuality, which can be a tremendous burden off the mind of the patient. On the contrary, those without health insurance may suffer long with no dagnosis and treatment. Non-proactivity leads to excessive worry about potential health problems.

Less lost time and more productivity: Health insurance coverage is an advantage to both the employee and employer as it provides a leeway for a quick and easy access to medical attention thus, minimising loss of time away from the work.

In summary, health insurance is important for both individuals and families, as it relieves the burden of any unexpected medical emergencies. The benefits of health insurance are clear; it increases access to health services whilst providing the means to seek medical attention without worrying much about the cost.

Therefore, our dear honourable members of Parliament emulate other African countries like Ghana that has successfully implemented this policy. Let your voices sound loud on expediting the national health insurance.

Writer is a Ugandan living in Germany