The South Dayi District Director of Health, Patience Nunoo has labeled co-payment at the various National Health Insurance Authority (NHIA) credentialed health facilities across the country including South Dayi as a necessary.
According to Madam Nunoo, although co-payment is bad and must not be encouraged, some situations at the health facilities require co-payment to save lives.
She was speaking at a stakeholders forum on co-payment on Tuesday at the South Dayi District Assembly.
The forum followed findings from a recent survey conducted by the District National Health Insurance Scheme (NHIS) which revealed that all the 11 health facilities in the district (1 District hospital, 1 CHAG, 5 health centres and 4 CHPS compounds) were illegally taking money from NHIS card holders.
Presenting the findings at the forum, the District Manager of NHIA, Mawuko Tsigbey said “pregnant women seeking ante-natal and delivery services are the worst victims of these illegal fees because they are made to pay the highest amounts compared to clients seeking general out-patient department (OPD) services.”
“These illegal fees were being collected at various units in the health facilities including the consulting room, laboratory, maternity unit, dispensary,” the survey added.
Co-payment is the illegal practice of NHIA credentialed healthcare provider charging a valid NHIS card holder a fee for services or medicines/treatments provided that are covered under the NHIS benefits package.
Currently, the country’s insurance model does not permit for a card holder and the NHIA to share the cost of treatment for conditions covered by the Scheme’s benefits package. Put simply, a condition and its treatment that is covered by the Scheme is covered fully and if it is not covered, the client bears the full cost of such treatment.
The Health Director said the health facilities struggle to provide health care to clients mentioning delays by the NHIA in reimbursing them and high prices of acquiring the items for the care delivery than what is on the NHIA tariff, thus, resulting in passing the difference to the patient.
The Acting Medical Supt of Peki Government Hospital, Dr Alphonse Makafui Dzakpasu who shared similar views with the Health Director said, their focus as health practitioners, is on delivery of quality health care and not just delivering health care.
Although he registered his displeasure about co-payments, he explained that sometimes situations compel them to suggest medicines to patients when those covered under the Scheme proved to lack the potency to cure their sicknesses.
The District Chief Executive for the area, Ernest Patrick Kojo Mallet observed that there was the need for consultations between key stakeholders in order to resolve complaints of low prices of NHIS service and medicine tariffs which seemingly were to blame for issues of co-payment.
Mr Emmanuel Avinu who represented Regional NHIA Manager called on health care providers to comply with the policy direction of the Scheme, explaining that the Authority has prosecutorial mandate to take on providers caught attempting to defraud the system.
He said the NHIA intends working on prompt payment of claims and asked that complaints of low NHIS tariffs should be communicated through the proper channels for review so as not to defeat the very purpose for which government established the Scheme.