Health insurance smells like a tax!
May 20, 2009
EDITOR—Is the health insurance scheme going to be run by someone appointed by the minister like NSSF and the URA? Is it going to be run like a subsidised monopolistic private firm or as a regulated private industry like the third party insurance compani
EDITOR—Is the health insurance scheme going to be run by someone appointed by the minister like NSSF and the URA? Is it going to be run like a subsidised monopolistic private firm or as a regulated private industry like the third party insurance companies in Uganda?
These management issues predict how successful the scheme may be. For example, the first two categories have some inefficiencies, as evidenced by the NSSF scandals like Nsimbe and Temangalo, the perception that URA employs and taxes selectively; and the fact that taxpayers subsidise Umeme—a monopolistic retailer of energy at prices perceived to be above the marginal costs.
The third category—third party insurance—is mandatory, yet the buyers (car owners) choose their preferred providers. Who are going to be the selected providers in the health insurance scheme?
Will the minister choose Mulago and other Government hospitals and health centres as the sole authorised provider of health services to all insured (like NSSF), or will the insured choose their providers as is the case with the third party insurance industry in Uganda? Could you please give workers, in addition to Cabinet and Parliament, a chance to read and debate the health insurance scheme before they sign up for it?
For now, the proposed insurance scheme in Uganda seems like a concept one of the commissioners in health is copying from the West and pasting on Ugandan workers, without considering typical Ugandan problems such as corruption, over-taxation, and poor service delivery by Government ministries and parastatals. The proposed health insurance scheme has many characteristics that make it look more like a health tax.
Muganga Kizito, Michigan, USA
These management issues predict how successful the scheme may be. For example, the first two categories have some inefficiencies, as evidenced by the NSSF scandals like Nsimbe and Temangalo, the perception that URA employs and taxes selectively; and the fact that taxpayers subsidise Umeme—a monopolistic retailer of energy at prices perceived to be above the marginal costs.
The third category—third party insurance—is mandatory, yet the buyers (car owners) choose their preferred providers. Who are going to be the selected providers in the health insurance scheme?
Will the minister choose Mulago and other Government hospitals and health centres as the sole authorised provider of health services to all insured (like NSSF), or will the insured choose their providers as is the case with the third party insurance industry in Uganda? Could you please give workers, in addition to Cabinet and Parliament, a chance to read and debate the health insurance scheme before they sign up for it?
For now, the proposed insurance scheme in Uganda seems like a concept one of the commissioners in health is copying from the West and pasting on Ugandan workers, without considering typical Ugandan problems such as corruption, over-taxation, and poor service delivery by Government ministries and parastatals. The proposed health insurance scheme has many characteristics that make it look more like a health tax.
Muganga Kizito, Michigan, USA