Members of the Society of Private Medical and Dental Practitioners in the Ashanti region have declared their inability to participate in the pilot Capitation exercise under the National Health Insurance Scheme (NHIS).
They would rather continue serving their clients based on existing contract with the health insurance authority.
The Regional Capitation Implementation Committee has set January 1, 2012 to begin the pilot capitation exercise in Ashanti, stating that 66 percent of active NHIS subscribers have been registered for the programme.
The Society is however apprehensive of the Capitation scheme, complaining petitions for a review of the scheme have not been acknowledged by the health authorities.
Ashanti Regional Chairman, Dr. Emmanuel Harry Tawiah, told a press conference in Kumasi that “the capitation in its present form would adversely affect the quality of care that we provide to our clients…all health indicators in Ashanti region will be negatively affected and it will be difficult to rectify the damages that will be done”.
The Capitation – per capita payments or money per person per period – involves advance payments to primary care service providers of a calculated and agreed amount of money per client per period.
According to him, clients in the region may be forced to pay out of pockets for medicines in the NHIS list because of the restricted scope of drugs under the capitation.
He is also worried the inclusion of maternal health under the capitation will affect indicators of maternal and child health.
The Society fears private health institutions in the Ashanti region and other public health facilities will collapse if the capitation is implemented in its present proposed form.
“Private health institutions are self-financing and the low capitated rate of GHS1.11 for services and GHS0.65 for medicines for enrolled clients per month is woefully inadequate to provide quality health care for our clients in the Ashanti region”, stated Dr. Harry Tawiah.
The Society has recommended, among other things, the upward review of the capitated rates for services, the exclusion of chronic and degeneration diseases as well as maternal healthcare from the capitation.
Members also want all medicines to be taken out of the capitation and the pilot period of implementation properly stated and defined.
Some members of the Ghana Registered Midwives Association have also joined in the call for the review of the NHIS Capitation.
But would the National Health Insurance Authority be willing to pay the private health practitioners their NHIS claims when they refuse to join the capitation?
“We will test the water” was the answer of Dr. Harry Tawiah.
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