Kampala, Uganda | URN | Every Ugandan will have to pay a minimum of 100,000 Shillings in annual premiums if they want to access health care under the National Health Insurance Scheme. According to the current bill, all persons aged 18 and above are liable to making contributions.
Employees in the formal sector are the biggest contributors with each being subjected to a four per cent deduction from their salaries while their employers contribute one per cent to the health scheme. However, individuals in the informal sector would be required to pay a proposed 100,000 Shillings annually while pensioners would be expected to pay one per cent of their monthly pensions.
According to the proposals, the poor, persons with disabilities, and refugees are not supposed to contribute to the fund, even though they will still receive healthcare. However, following stakeholder consultations where it emerged that employed Ugandans do not agree with the proposal of paying while others do not, it was agreed that all persons will be required to pay to receive the services. This includes the poor and persons living with disabilities.
An actuarial study carried out by the Insurance Regulatory Authority, for the health insurance scheme to be successful, all Ugandans will have to pay a minimum of 100,000 Shillings annually. Benson Kwikiriza, a senior legal officer in charge of regulation and drafting at the Insurance Regulatory Authority, one of the organisations working with the health ministry on the scheme says the money is needed to offer quality health care. According to Kwikiriza, this amount is affordable for all Ugandans given the services that will be received.
On the open market, persons with health insurance pay between 500,000 to 700,000 Shillings to be able to receive some of the services that the national scheme will offer. This money for instance covers health checks, antenatal services, deliveries, eye care, dental and even skincare but to a certain extent. However, treatment of complex ailments such as cancer, heart disease is often not covered.
Data from the Uganda Bureau of Statistics show’s that 19.7 million Ugandans are aged 18 and above as of 2020. If each Ugandan is able to afford to pay a premium of 100,000 the scheme would be able to collect Shs 1.9 trillion annually. According to Kwikiriza, the contributed funds will help the government offer quality specialised care. However, health economic specialists say the proposed monies will not be able to offer all health services.
Prof Freddie Ssengooba, an expert on health economics and health systems management says the proposed monies are not enough for the health system as it stands to offer specialised care. He says contributors will likely have to pay more money to get specialised services.
Dr Fred Muhumza, an economist says that what is being proposed can not work since many Ugandans can not afford to put aside 100,000 Shillings for health care. The 2016 Uganda National Household Survey shows that more than a fifth of Ugandans live on less than 200,000 Shillings a month
“This proposal is not viable. The policymakers are making the assumption that people have money and that government can offer the services. Our experience that we have seen especially during COVID is the government system cannot offer the needed services. I say let them leave people with their 100,000 so that they can seek health care from wherever they want,” he said.
However, officials at the health ministry said the monies contributed cannot correspond to the services that will be offered. They say if Ugandans were asked to pay for what they would receive, the premiums paid would be more than triple what is proposed.
Last week during a press conference, the minister of health, Dr Jane Ruth Aceng said that the monies being contributed by everyone are to enable a sense of ownership which is vital for the scheme to be successful.