On 31st March 202021, Members of Parliament passed the National Health Insurance Scheme (NHIS) bill, which seeks to provide universal healthcare to all Ugandans. However, before its’ passing, the State Minister of Health Hon. Robinah Nabbanja had made it clear to the House that the Bill in its current state needed to be withdrawn pending consultations from stakeholders. My feeling though is that instead of withdrawing the Bill, the Minister ought to have asked for some more time before Parliament considers the Bill.
Nonetheless, the Hon. Minister informed the House that there was still need to carry out an analysis of the premiums on how much and what percentages the formal and informal employees and employers would contribute to the Scheme. She informed members of the August house that implementation of the Scheme was pending an ongoing actuarial study undertaken by the Insurance Regulatory Authority of Uganda (IRA) which is a key outstanding issue that will largely affect universal enrollment of the population to the scheme.
The IRA and the insurance industry are in support of the fundamental principle of establishing the Scheme because it will safeguard families from financial hardships as a result of huge medical bills.
We are all aware that our total health expenditure or budget is currently at close to Shs8trillion. Given the Country’s population explosion, the demand for health services and facilities is increasing every other day. Over the years, we have noted that the out of pocket expenditure on health for an individual in Uganda currently stands at 41% yet any out of pocket expenditure that goes beyond 10% is catastrophic. It basically implies that families are not having enough resources to cater for other basic needs like food, shelter, and clothing among others. We have on various occasions witnessed patients being detained in hospitals and health centers for failure to clear their medical bills. Others especially expectant mothers have not received the necessary attention for failure to have the basic need like “mama kits” to facilitate the nursing team at the health facilities to support them while delivering their babies safely. The Scheme is meant to address and safe guard families in such instances because the patient will not need money at that time in order to access essential health care.
As government rallies the country into the middle-income status, with the Scheme in place, households shall be protected from impoverishment due to high expenditures on health and saving from medical expenses which will be channeled to domestic development. In addition, members of the scheme will be able to access facilities that are accredited on the Scheme at their convenience.
Whereas Members of Parliament and government are setting the right direction in establishing the Scheme, it’s important that the implementation of this Scheme takes matters of professionalism, technical design, affordability for the common person, total transparency (especially financially) and sustainability through reduced administration costs into consideration.
To ensure good implementation of this Scheme, there is need to identify and cluster people affected with minimum benchmarks set through development of regulations and guidelines.