The Minority in Parliament has called on the finance minister to as a matter of urgency release all collections of National Health Insurance Levies (NHIL) to the National Health Insurance Fund (NHIF) without delay.

According to the Minority, the current situation of owing claims far above the statutory limits cannot be acceptable under these precarious economic situations.

“Government must, as a matter of urgency, revert to the regular and reliable schedules as envisioned in the NHIA Act and report to parliament as required,” a Minority statement signed by Mr Kwabena Mintah Akandoh, Ranking Member Parliamentary Select Committee on Health, said.

The statement comes on the back of threats by private health facilities to introduce top-up payments for National Health Insurance Scheme clients due to the unprecedented levels of inflation and the non-payment of claims by the National Health Insurance Authority.

The Minority, however, is pleading with manufacturers, importers and wholesalers of pharmaceuticals and private health service providers to delay the imposition of top-up costs to reduce mortality and morbidity even as they try to engage government to release all collections of NHIL to the NHIF.

Read the Minority’s full statement below:

STATEMENT BY THE MINORITY IN PARLIAMENT ON THE RECENT THREAT BY THE PRIVATE HEALTH FACILITIES ASSOCIATION OF GHANA TO INTRODUCE TOP-UP PAYMENTS FOR NHIA CLIENTS

The Minority in Parliament has taken note of a statement issued by the Private Health Facilities Association of Ghana in which it threatened to pass on top-up payments to NHIS clients within their facilities. This they claim is due to extensive delays in the payment of claims by the NHIA, the Ghana Cedi Depreciation and the rising inflation on drugs and non-medical consumables. Unconfirmed reports suggest that some facilities have already started passing on these top-up costs to their patients.

As alarmed as we are by these reports, we are not surprised considering the current economic conditions and the fact that government has not responded to the series of statements, appeals and threats made by various players within the pharmaceutical value chain.

On the 19" of October this year, a joint press statement was issued by the GHANA NATIONAL CHAMBER OF PHARMACY (GNCOP), the PHARMACEUTICAL MANUFACTURERS and the PHARMACEUTICAL IMPORTERS & ASSOCIATION OF GHANA (PMAG), WHOLESALERS ASSOCIATION OF GHANA (PIWA) warning all concerned that they were no longer going to give credit to health facilities. They cited the unprecedented levels of inflation and the non-payment of claims by the NHIA as reasons for which they are withdrawing all credit lines to health facilities. We expected that government would have intervened with appropriate measures such as transferring to the NHIF all outstanding collections of NHIL and SSNIT contributions as mandated by the National Health Insurance Act 2012 (Act 852) Section 52(1). This intervention never happened.

Unfortunately, there rather seems to be an unwavering effort to collapse the National Health Insurance Scheme by depriving it of funds. As we speak, the highest release of NHIL levies collected was in 2016 when 86% of collections were released to the NHIA. The lowest on record is that of last year where government out of the GHS2.056bn it collected paid only GHS 127m or 6.2% to the NHIA fund. We have issued several statements calling on the Minister for Finance to release National Health Insurance Levies and the component of SSNIT contributions meant for the scheme to the National Health Insurance Fund all to no avail. After several weeks, the Private Health Facilities Association of Ghana have also threatened to pass on top-up payments to NHIS clients who use their facilities. This foreboding news wreaks fear in the hearts of many who frequent healthcare facilities across the country.

It is trite knowledge that inflation has been spiralling out of control for some months now due in part to central bank financing of the budget leading to a situation in which inflation has exceeded the Bank of Ghana’s upper limit of 10% and currently stands at two decades-high 40.4%. This has impacted the pricing of all goods and services from food, fuel, and other consumables, and has eliminated disposable incomes and savings previously used to finance healthcare costs.

Under the current economic conditions more Ghanaians, than ever before, will require the National Health Insurance Scheme to finance their medical needs. It is therefore unconscionable for government to hold on to monies collected in the name of the NHIA rendering it incapable of meeting its obligations to service providers.

This is going to increase morbidity and mortality across Ghana.

As we speak, patients in some hospitals across the country are being asked to make upfront payments for medical consumables and services. This is likely to increase morbidity in persons with hypertension, diabetes, sickle-cell anaemia, HIV, and other conditions who require regular intake of medical consumables and services resulting in undue stress on already overburdened medical facilities.

If nothing is done, we foresee high mortality rates among patients who lack the resources to pay for the services of healthcare providers or delay presentation at health facilities.

The demand for the National Health Insurance Authority to clear at least 6 months of submitted claims and provide one month's reimbursement every month is apropos.

However, as Members of Parliament, we will want to caution the finance minister to as a matter of urgency release all collections of NHIL to the National Health Insurance Fund without delay.

The current situation of owing claims far above the statutory limits cannot be acceptable under these precarious economic situations. Government must, as a matter of urgency, revert to the regular and reliable schedules as envisioned in the NHIA Act and report to parliament as required.

We also plead with manufacturers, importers and wholesalers of pharmaceuticals and private health service providers to delay the imposition of top-up costs to reduce mortality and morbidity even as they try to engage government on this matter.

The health of our citizens is in the balance and our National Health Insurance Scheme must not be allowed to collapse.

Thank you.

Kwabena Mintah Akandoh

(Ranking Member Parliamentary Select Committee on Health)