Service providers blamed for near collapse of National Health Insurance

Greed, selfishness and unpatriotic conduct of some health care providers, had been identified as the underlying factors for the current financial challenges faced by the National Health Insurance Scheme (NHIS).

Mr Rojo Mettle-Nunoo, the Deputy Minister of Health, said service providers had over the years, abused the claim regime and colluded with unscrupulous scheme officials to claim huge sums of money, which nearly paralyzed the scheme.

They prepared fictitious claims while others inflated figures. Besides, accredited pharmaceutical companies also failed to stock about 80 per cent of the drugs that are required under the scheme.
He told an NHIS-Providers forum in Kumasi on Thursday, that the human factor was to blame for the problems that bedevilled the NHIS operation, adding that, delays in claims refund are due to proper scrutiny by internal auditors.

The forum brought together key stakeholders, including Medical Superintendents, regulatory bodies, public and private service providers, to brainstorm and understand each other’s challenges, share their difficulties and fashion out common values, approaches and standards to inject efficiency into the scheme.

Mr Mettle-Nunoo said the NHIA was determined to bring about sanity and efficiency and called on the service providers to endeavour to do the right things.

“What should concern all stakeholders is to ensure that the scheme works for the benefit of all. Service providers should set tradition and leave legacy for future generations.”

Mr Mettle-Nunoo appealed to the NHIA to ensure that part of the tariffs, was channelled into the maintenance of equipment and infrastructure of health facilities to give practitioners satisfaction.

Mr Sylvester Mensah, Chief Executive Officer of NHIA, said the scheme had made progress in tackling some of the challenges the scheme was faced with.

Thorough clinical auditing throughout the country had uncovered and removed abuses, he said, pointing out that, three scheme managers and officers are currently in prison custody, with 33 others on interdiction for cheating on the system.

Dr Elias Sory, Director General of the Ghana Health Service, said it was in the interest of service providers to collaborate effectively and contribute to the sustainability of the scheme.

They should also have a better understanding of the laws establishing the scheme to ensure its smooth implementation, he said.

Source: GNA

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