The government is considering the option of using part of the country's oil revenue for the intended one-time premium payment of the National Health lnsurance Scheme (NHIS), the Vice-President, John Dramani Mahama, has announced. He said considering the critical role of good health of the citizens in national development, there was the need to explore innovative options to sustain healthcare financing in the country. Opening the 10th annual public lecture of the Ghana Medical Association (GMA) in Accra yesterday, Mr Mahama said it was the decision to find new and innovative ways of financing universal access to healthcare that informed the government's commitment to implement the one- time premium payment. The annual lecture was on the theme: "National Health Insurance Scheme (NHIS): Opening Dialogue for Universal Coverage." The Vice-President disclosed that the Cabinet had referred proposals for the one-time premium payment to its subcommittee for consideration. The one-time premium payment has remained one of the cardinal objectives of the government and the effort to explore the avenues of using part of the oil revenue is consistent with the government's determination to achieve that objective. Since its inception in 2004, the Health Insurance Scheme, which is managed by the National Health Insurance Authority (NHIA), has become the source of funding for health care for many Ghanaians. The NHIS has also grown in various aspects of its operations, and is perceived as a model social health insurance scheme in Africa and beyond. Beginning with a membership of 1.3 million in 2004, the scheme now has a database of more than 15.5 million registered members representing more than 60 per cent of the population. Member utilisation rates grew exponentially from 9.9 million in 2008 to 17.6 million in 2009, representing a 75 per cent increase. Mr Mahama said the government was of the belief that for a comprehensive exposition and analysis of challenges facing the NHIS, it was a useful exercise not only to ensure transparency but also strengthen the scheme in order that it could provide the expected service to the people. "There is no easy road to construct a perfect health insurance system. As experience has shown in the United Kingdom (UK) and the United States of America (USA), health care reform is a very difficult road to travel. It requires determination and perseverance to move forward in health reform," he said Mr Mahama acknowledged that reimbursement of premiums to health facilities had not been regular and attributed the situation to ongoing reviews of internal procedures and regulation within the scheme in order to bring sanity into its operations. "As you may be aware, the implementation of any national policy is bound to face challenges; and the NHIS is not an exception. Government is aware of some of the challenges," he stressed. He mentioned some challenges confronting any policy implementation as lack of sufficient technical capacity of claims processing staff both at the provider and scheme levels, inadequate numbers of claim officers; and, in many cases, downright fraud. The Vice-President lauded the GMA, which had over the years, as far back as 1971, played an important role in healthcare delivery, particularly, suggesting reforms in terms of healthcare financing. "This strong advocacy role by the GMA together with others culminated in the passage of the National Health Insurance Act 650, in September, 2003," he said. "It is, therefore, heart-warming that the association has today assembled experts, including yourself, to discuss the challenges facing the NHIS," he noted. The Chief Executive Officer of the National Health Insurance Authority, Mr Sylvester Mensah, stated that since its inception in 2004, the scheme, had evolved to become the funding source for health care for many Ghanaians - both rich and poor. Starting from a membership base of 1.3 million in 2004, the scheme today has a database of over 15.5 million registered members, representing over 60 per cent of the population. He said between 2008 and 2009 alone, member utilisation rates grew exponentially from 9.9 million in 2008 to 17.6 million in 2009, representing a 75% increase. He noted, that while the phenomenal increase in membership represented a major step in the path towards universal health care, the increase in utilization rate represents the growing confidence subscribers have in the scheme. Mr Mensah added that since the beginning of the year, the authority, through its claims processing centre and improved systems, had consistently paid claims within 60 days of submission. He called on service providers to help fight the abuse and error that is plaguing the system. The President of the GMA, Dr Emmanuel Adorn Winful, cautioned against over-emphasising fraud as the main challenge confronting the NHIA, while overlooking fundamental systemic issues that contributed and even generated some of these perceptions. "Where fraud is proven, however, the Ghana Medical Association wishes to put it on record that this will never be supported," he said. He called for a proper re-examination of financing of the scheme, particularly since currently, outflows exceeded inflows. The Minister of Health, Dr Benjamin Kunbuor, said as the issue of the merits and demerits and of the policy came to the table, there was the need to take cognisance of the fact that the scheme was unique in many forms and that there were a lot of lessons for other countries. "It is our responsibility to give to the developing world a system which, when well managed, may prove to be a major breakthrough in healthcare financing in the future," he said. Source: Daily Graphic