The one-time premium payment under the National Health Insurance Scheme (NHIS) becomes operational from January next year in fulfillment of one of the key pledges of the government.
To achieve that, a review of Act 650 to give legal effect to the one-time premium is currently before Cabinet and will soon be put before Parliament.
The Chief Executive Officer of the NHIA, Mr Sylvester Mensah, made this known at the launch of the sixth edition of the Standard Treatment Guidelines (STGs) and Essential Medicine List in Accra yesterday.
The road map to the implementation of the one-time scheme is also currently before the government and this will help determine the modalities on whether all categories of people should pay one amount or various categories of people should be made to pay different amounts and other requirements.
When passed, Mr Mensah said, the NHIA Bill would pave the way for radical changes in the country's present health insurance scheme.
He said the NHIS was presently bedevilled with numerous challenges and that it would benefit a lot from the development of the 2010 STGs.
The STGs are clinical protocols that provide physicians, midwives, pharmacists and community health workers with evidence-based recommendation and guidance on the appropriate treatment of common diseases and medical conditions.
Previous protocols were developed in 1988,1993,1996,2000 and 2004.
"One of the biggest issues facing the NHIS is irrational prescribing, with its cost implications and inherent threat to the sustainability of the scheme," Mr Mensah said.
He added that •clinical audits and claims verification exercises had shown that many of the problems facing the NHIS had to do with prescriptions not in June with the Ministry of Health's (MOH's) laid down policies on treatment.
He said the NHIA had decided to embark on a number of cost containment measures which would depend heavily on the STGs, such as linking treatment recommended in the guidelines to diagnosis covered under the NHIS to improve quality of care, among others.
He said the NHIA was hopeful that the usage of the STGs would help minimise treatment variations and promote the appropriate use of the most cost-effective treatments and provide guidance for health professionals on the diagnosis and treatment of specific clinical conditions.
The Minister of Health, Dr Benjamin Kunbour, said the government was examining ways of injecting new dynamism into the health infrastructure at a rate and level that would respond to the increased utilisation of services caused by the introduction of the NHIS.
He said the use of the guidelines would be critical in contributing to the sustainability of the country's NHIS, saying that under the new regime, reimbursement for services provided would largely depend on the national health insurance medicines list which must be derived from the STGs.
He added that the development of the STGs was a key instrument designed to enhance the implementation of the National Drugs Policy and the essential drug programme which was also aimed at ensuring the availability of safe and efficacious drugs, as well as creating an environment for rational drug use.
The Director of Pharmaceutical Services at the Ministry of Health, Mr James Ohemeng Kyei, said the STGs had been systematically developed to assist in ensuring that drug use in the country was professionalised.
Representatives from the World Health Organisation (WHO) and the Royal Netherlands Embassy praised the country for developing the guidelines and pledged their continuous support to ensure that the health needs of the people were adequately catered for.
The Deputy Director-General of the Ghana Health Service (GHS), Dr George Amofah, who chaired the ceremony, said the STGs would help improve clinical care in particular and health care in general.
Source: Daily Graphic
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