National Health Insurance Scheme (NHIS) card holders may have to brace themselves for out of pocket payment following the decision by public and private healthcare providers to suspend the provision of medicines to them.
This was contained in a joint statement by the Ghana Health Service (GHS), Christian Health Association of Ghana (CHAG), the Society of Private Medical and Dental Practitioners (SPMDP) and the Ghana Registered Midwives Association (GRMA) over non-payment of NHIS fees to members of the associations.
“Due to over seven months indebtedness of the NHIA to all healthcare providers, health institutions are unable to maintain the basic quality of care required of them.
“Health institutions lack the necessary medical and surgical supplies because pharmaceutical companies have refused to supply medicines and other consumables on credit. The leaderships of the GHS, CHAG, SPMDP and GRMA feel embarrassed by this development,” they said in the statement.
The NHIA Chief Executive, Sylvester Mensah, last month pledged that the authority was going to offset all arrears by the close of March, but few days to the month end, there is no sign for the payment leading to the reintroduction of the dreaded cash-and-carry system.
The group, however, added that if NHIS card holders would be attended to by healthcare professionals, they would have to buy medications and pay for other costs that may come with their healthcare services.
The Executive Director of CHAG, Peter Yeboah, speaking to a local radio station said the action is a “distress call” meant to draw the attention of the National Health Insurance Authority (NHIA).
Although he did not refer to the change as cash-and-carry because they would be providing medical services, he said that when NHIS cardholders come to the hospitals, they would be made to buy their own medication and other consumables.
Mr Yeboah said the health providers have been forced to take public-private partnership arrangements in order to recoup costs incurred in providing healthcare.
“It is only a special arrangement,” he said, not cash-and-carry.
He said if the NHIS should reimburse them, they would revert to the old policy but still look forward to a more sustainable way of implementing the NHIS policy.
Warning Signs The NHIS policy was introduced in 2006 to replace the killing cash-and-carry system.
However, the policy has gone through turbulent challenges over the past few years, with service providers crying over debts owed them by the NHIA.
Various healthcare providers and organisations have over the past months threatened to withdraw services to NHIS card holders over unpaid claims owed them by the authority which is running into over GH¢500 million.
Last week, the Society of Private Medical and Dental Practitioners (SPMDP) threatened to suspend their services to NHIS card holders if the NHIA does not refund monies due its members within six weeks.
Hospitals in the Volta Region in February this year also threatened to return to the cash-and-carry system if the NHIA does not pay monies owed them within 30 days.
The Ghana Chamber of Pharmacy nearly cut supply of medicines to health facilities that depend on the NHIS to pay for their drugs last year also because of unpaid monies.
Experts in the health sector have attributed the current situation of the NHIA to funding gaps of the scheme, warning that the trend could collapse the scheme.
In 2013, claims payment made by the NHIA reached GH¢785.64 million, with Mr Mensah indicating that the scheme spends GH¢3 million a day on healthcare bills for its members across the country.
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