Former Director General of the Ghana Health Service, Prof. Agyemang Badu Akosa, said staff of National Health Insurance Scheme (NHIS) should be paid on commission rather than guaranteed monthly salaries.

He told Adom News the commission should be based on how many new people each worker registers on the scheme every month.

This, he said, would push the workers to step out and start registering people unto the scheme just like the workers of other insurance company do before getting paid.

Prof. Akosa argued that registration on NHIS is low because the workers receive their month salaries whether they register more people or not, and that is why the scheme is collapsing.

He said many staff of the district mutual health insurance scheme do not go out to encourage contributors to register with the NHIS but rather sit in their offices and expect Ghanaians to go to them to register, and at the end of the month expect their salaries.

After eight years of NHIS "I say we are not doing well," he stated.

Speaking earlier at a day’s workshop on Sustainable Healthcare Financing for the NHIA in Accra, Prof Akosa said if the NHIA collects the premiums correctly, the nation would reap about GH¢91 million if each contributor pays a flat rate of GH¢10 each, and that alone is enough to sustain the scheme.

He further proposed that the subscription to the scheme, must be made compulsory to all Ghanaians so that there would be a lot of people paying the premium, so that the cost would be low, adding “if car insurance policy is compulsory, then I do not see why the same cannot be applied to health".

He emphasised that by making the payment of premiums flexible and culturally friendly, people who do not have physical cash to pay their contributions, could barter with products, such as cattle or ram, as a form of premium, or be made to enjoy the scheme in the “off seasons,” so that they can pay later when their products are harvested.

The former GHS Director-General said as a first step towards improving the running of the scheme, the managers and the fund and administrative staff at NHIA should be separated from the district mutual health insurance scheme staff who go out and register people unto the scheme.

He however noted that appointment to the NHIA must not all be political appointments otherwise the scheme would remain polarized and fail eventually.

Prof. Akosa suggested that available positions should be advertised in the media for people to apply and be selected based on competency and not on political patronage.

Meanwhile a former Health Minister under the erstwhile Kufuor administration, Dr. Richard Anane has agreed with Prof. Akosa that wages to NHIA staff should be on commission.

Dr. Anane said it was in the original plan of the scheme that not all staff should be paid monthly.

He said those in charge of collecting premiums must not be paid monthly as in the original plan, but be paid commissions based on the number of people they are able to register on the scheme.