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Sylvester Mensah, Chief Executive Officer (CEO) of the National Health Insurance Authority (NHIA), has said increasing enrolment of subscribers coupled with payment claims are the major challenges facing the sustenance of the scheme. On that score, the NHIA is pressing proposals to expand the life of the scheme with a proposed levy6 on tobacco, alcoholic beverage as well as the road fund and the communication service levy/tax. Mr. Sylvester Mensah gave the hint at a two-day workshop at the Accra International Conference Centre (AICC) in Accra last Monday to mark the 10th anniversary of the establishment of the NHIA. �And this has to do with increase in the National Health Insurance levy option, review of exemption on National Health Insurance Levy, looking at additional funds from the road fund, looking at levy on tobacco and alcoholic beverages, looking at 20 percent of communication tax assigned to health insurance and also looking at levy from the petrochemical industry.� The National Health Insurance Authority Chief Executive further mentioned that the Authority spends more than 50 percent of its revenue on payment of pharmaceuticals � a situation that needs to be immediately solved. �We still have a few challenges with our pharmaceutical supply chain, medicines in Ghana within the context of our claims payment, account for well over 52 percent of our claims� Mr. Mensah noted. According to him, in countries such as South Korea and others, medicine accounts for less than 27 percent of their claims, and pointed out that the pharmaceutical supply chain in Ghana is inefficient, adding that �it is one key area that health insurance can be without the inefficiency�. He therefore expressed the authority�s conviction to focus on addressing the inefficiencies in the pharmaceutical supply chain and also testing the laws that establish the health insurance scheme to determine the extent to which the challenges could be addressed. The Minister of Health Mrs. Shirley Ayittey in her welcome said the National Health Insurance Scheme has come to play an important part in Ghana�s health system, accounting for over 85 percent of internally generated funds of public and faith-based health facilities. She added that he impact is not only in the public sector, but also in the private sector where up to 90 percent of the revenue of some private healthcare providers comes from the National Health Insurance Scheme. �There is no gainsaying the fact that the NHIS has become critical in the financing of healthcare in Ghana and has made auxiliary contributions to the growth and development of the private healthcare�, she noted. According to her the ten year story of the National Health Insurance Scheme cannot be told without mentioning the contribution of the international body of knowledge to the progress they have made so far as a nation. She indicated that the National Health Insurance is still young, but old enough to confront the realities of our time and that I is in the recognition of the complexity of health systems all over the world that Ministry of health, working in close collaboration with the National Health Insurance Authority, supported the idea of designing a forum to bring together global thought leaders to deliberate on Ghana�s current and future trajectory towards Universal Health Coverage. A Minister of State at the Presidency, Dr. Ahmed Mustapha who represented President John Dramani Mahama challenged the National Health Insurance Authority to develop systems devoid of human interference to help address the inherent inefficiencies of the scheme to contribute to its sustainability. He said government will spare time and attention to correct the inefficiencies in the use of resources as it considers options for increasing funding. The just ended three day conference was under the theme: �Towards Universal Health Coverage; Increasing Enrolment whilst Ensuring Sustainability� and with sponsorship from the Rockefellower Foundation, Japan-World Bank Partnership Program for Universal Health Coverage, Ministry of Health and other organizations.