Health insurance clients compelled to pay for drugs

Clients of the Ho Municipal Mutual Health Insurance scheme have to pay for drugs under the scheme through suspected manipulation by some service providers and below-the-market-price quotations by the National Health Insurance Authority (NHIA).

This came to the attention of the Ghana News Agency from observations and information gathered at the Volta Regional Hospital, a designated pharmacy in the municipality and the Ho Municipal Mutual Health Insurance Scheme.

Desperate relatives of patients were sometimes compelled to pay for those drugs in the wards without receipts being issued.

A source at the Regional Hospital pharmacy alleged that anytime the pharmacy took delivery of the drugs, the wards put in requisition for them, leaving the pharmacy virtually empty.

A patient said he recently bought GH¢116.50 worth of drugs under the scheme because the drugs were allegedly not available at the hospital pharmacy and the designated pharmacy in town.

It was later found out that the drugs were dispensed from the pharmacy to the ward but somehow the client was given prescriptions of those drugs and directed to go for them at a health insurance designated pharmacy in town which said the drugs were not available.

This compelled that client to buy the drugs at a different pharmacy.

The client has filed a complaint with the Ho Municipal Mutual Health Insurance Scheme for remedy for breach of contract.

A source at the designated pharmacy told the GNA that because the prices quoted by the Scheme on its drug list were far below the market prices they were compelled to either sell the drugs to the clients or told them that the drugs were unavailable.

Mr Prosper Pi-Bansah, the Ho Municipal Scheme Manager, said the prices of the drugs under the Scheme had not been reviewed for one year now.

He said under the circumstances the Municipal Scheme had to engage the designated pharmacies in a constructive manner to get them to sometimes reluctantly serve their clients.

Mr Pi-Bansah said price quotations for drugs on the health insurance list must vary depending on location because prices of drugs elsewhere in the country could not be tied to those in Accra.

He urged the media to focus attention on alleged malpractices in designated health insurance service facilities which tend to undermine the laudable intentions behind the scheme to give it a bad name.

Mr Dickson Nuku Dansu, Claims Manager of the Ho Municipal Mutual Health Insurance Scheme, said the scheme is facing some genuine problems but “there are also problems which arise from criminality by some service providers”.

He said the Scheme was inundated with huge bills some of which were found to be fraudulent.

Mr Dansu said whereas some aggrieved clients were quick to complain to the scheme, they are unwilling to help the scheme to investigate complaints for fear of victimization by service providers.

Mr Christopher Midodzi, the Pharmacist at the Volta Regional Hospital, said the pharmacy issues drugs to the wards as units for emergencies and specifically for treatment of in-patients.

He said where patients are clients of the Health Insurance schemes no monies are expected to be collected from them in respect of drugs and other services covered by the schemes.

Mr Midodzi said his department was not aware of allegations that nurses sold drugs prescribed by doctors for health insurance card bearers or kept the drugs issued and demand that they buy them in town.

Source: GNA

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