Elections delaying National Health Insurance

HEALTH|INSURANCE|ELECTIONS

The current political activities in the run-up to the 2021 general elections are delaying the process of attaining the National Health Insurance Scheme (NHIS), the chairperson of the parliamentary committee on health has observed.

Dr Michael Bukenya (Bukuya County MP), the chairperson health committe, said they had expected that by this time, the drafting of the report on the Bill would be complete, unfortunately, due to the election period, they are going to experience further delays.

Bukenya said the Speaker of Parliament, Rebecca Kadaga, had proposed a recess until party primaries are complete.

‘‘We are struggling to find time as committee members to meet the minister responsible in order to finalise the report and forward it to the clerk of Parliament,'' he said.

This was during a media engagement at the Golf Course Hotel in Kampala, organised by Partners for Population and Development Africa, Reproductive Health Uganda and Marie Stopes Uganda to discuss the NHIS Bill 2019 on Tuesday.

Last year, the Government tabled the NHIS Bill 2019, which was referred to the committee of health for scrutiny.

The committee produced a draft report to be discussed by the committee and the health ministry, before it is tabled in Parliament for the second reading.

The objective of the scheme is to develop health insurance as a mechanism for financing healthcare. The scheme will facilitate the provision of equitable and affordable healthcare.

The proposed scheme requires hospitals to provide a wide range of services for both inpatient and outpatient, reproductive health, HIV/AIDS symptomatic treatment, emergency care and antenatal care.

It also provides for dental care, eye care, mental health, radiological investigations, imaging services, surgical services, mortuary services and laboratory investigations.

Who is targeted?

The Bill targets any person who attained the age of 18, ordinarily resident in Uganda.

Salaried employees will have deductions made from their salaries by the employer, with a contribution from the employer, while self-employed person will make an annual contribution.

During the discussion, the legal counsel to the committee, Ronald Bagaga, said contribution is based on income by the board in consultation with the health and finance minister.

The Bill stipulates that contributions by selfemployed persons shall be prescribed by the board and failure to pay attracts a penalty five times the amount.

The Bill further states that an employee of the scheme who receives and keeps scheme funds or misappropriates, permits another to do through neglect or abandonment, will be fined not exceeding 200 currency point or two years imprisonment.

Who is to benefit? 

The Bill states that every contributor, spouse and child of a contributor are entitled to benefits. However, the benefits do not cover treatment or supply of medicine where the healthcare provider did not diagnose the illness or injury.

In addition, if the cost of healthcare exceeds the amount prescribed, extra cost is on the patient to whom the health services are offered. Bagaga said: ‘‘By principle of law, the community insurances are not prohibited. They would run alongside the Government scheme.

‘‘In our engagement with the community health insurance providers, they proposed that they be included in the law and regulation of relationship between them and government health insurance.''

The desk officer NHIS, Aliyi Walimbwa, said in East African Community, it is Uganda and South Sudan that do not have any form of insurance.

Health expenditure 

The health expenditure by source, according to the National Health Accounts report FY2014/15 and 2015/16 was 15%-17% from the Government, 37% from donors, 41% from individuals out of pocket and only 1%- 2% from pre-payment mechanisms, such as health insurance and community payment mechanisms.

The annual per capital total health expenditure is $53 (sh193,450), which is below the recommended minimum of $84 (sh306,600).