A report submitted by a research conducted by the management of Strategies for Health Insurance for Equity in Less Developed Countries (SHIELD) has revealed.
It said progressive countries were those where people with higher incomes contributed greater percentage of their incomes to fund health services compared to those with lower incomes.
At a dissemination meeting held in Accra on Tuesday, the report said Ghana had taken a bold step in relation to mandatory insurance by embarking on a national health insurance system within which district-wide community based schemes were an integral component with rapid increase in coverage.
Professor John Gyapong, Director of Research and Development Division, Ghana Health Service (GHS), said the research was to evaluate existing inequities in Ghana, South Africa and Tanzania and the extent to which health insurance mechanism could address these equity challenges.
The key components of SHIELD were to evaluate the distribution of the burden of paying for health care across socio-economic groups and the extent to which health care payments impoverish households.
Others are to evaluate the distribution of the benefits from using health care across socio-economic groups relative to their need for health care.
It is also to identify and critically evaluate health care financing options that could address existing inequalities including modelling the resource requirements and feasibility of these health financing system changes.
Prof. Gyapong said Ghana was well known for her extensive experience of community based mutual health organisation, while Tanzania had a growing experience of community based pre-payment schemes and was known for her Community Health Fund (CHF) schemes introduced in 1996.
He said in contrast, South Africa had no experience of community based pre-payment schemes; instead she had substantial private voluntary insurance covering middle class and high income formal sector workers which were almost non-existent in Ghana and Tanzania.
The report said all the three countries were either planning or implementing some form of mandatory health insurance, and South Africa had progressed the least, but currently in the process of agreeing to the policy framework for mandatory insurance.
In Tanzania, although the civil servant insurance and that of the informal sector were not yet linked, integration of CHF with the mandatory civil servant scheme would soon be initiated.
The report said tax was an important source of funding in all countries however; Value Added Tax (VAT) was regressive in South Africa but progressive in Ghana and Tanzania.
Deputy Health Minister Rojo Mettle-Nunoo said Ghana had a unique insurance system which had become a model for many African countries and urged stakeholders to depoliticise the scheme and help it work for the benefit of all Ghanaians.
He said the exempt group made up of pregnant women, children and the aged was increasing the number of pro-poor.
Dr Sam Adjei, Chief Executive Officer of Centre for Health and Social Services (CHeSS) urged the research division of National Health Insurance Authority (NHIA) to build capacity development among staff and have a strong research component to collect, analyse and make use of the data to enable decisions made be evident-based.
Prof. George Ankra Badu, Member of GHS Council, said issues of inequities in the health sector had made it mandatory to review who paid what, barriers that made it impossible for access and those who benefited from it to make health care affordable and available.
Mr Sylvester Mensah, Chief Executive Officer of NHIA, said a lot had changed since 2008 when the research was undertaken.
He said the exempt group of insurers consisted of 70 per cent of the population but noted that the scheme could not cater for the entire population adding that the benefit package that Ghana had was the most charitable.