The Independent Uganda: You get the Truth we Pay the Price
Kampala, Uganda | THE INDEPENDENT | Experts and players in the health sector are asking the government to do away with its free healthcare for all policy as the as Uganda moves to come up with the National Health Insurance scheme.
Grace Kiwanuka, the Executive Director of Uganda Healthcare Federation told Uganda Radio Network that having the scheme working could take us decades but the government needs to urgently inform the community that free healthcare is not tenable.
Kiwanuka said that the new draft National Health Insurance Bill 2019 that has just been sent to parliament will work best if inclusion is expanded to a community level by scaling up groups that are already organized to provide healthcare at a community level for very low premiums. She said the scheme is structured uniquely for Uganda and can’t be compared with others.
However, according to Kiwanuka, the scheme is not a silver bullet that will sort out Uganda’s health sector challenges and indicators. She also cautions that the scheme will take decades before yielding results.
Dr Sam Okuonzi, a Health Policy Researcher and former head of policy analysis at the Ministry of Health concurs with Kiwanuka and warns that policymakers might blunder with the excitement around the bill.
He said the bill was drafted under pressure, a reason as to why they announced its passing by cabinet even before a draft could be made. He said even countries that have their schemes working, focused on specific issues that were uniquely affecting them as individual countries.
Here, coming up with the law that provides for having the scheme started as early as 2009. But several drafts have since been made and dropped until the end of this August when a new draft was signed by the Health Minister and sent to parliament.
While previously, contributions in terms of percentages were proposed, the new draft doesn’t spell out what’s to be contributed though it says both salaried and unsalaried Ugandans will make contributions to the fund. While salaried employees will have their salaries deducted monthly by their employers, the self-employed will make annual contributions.
The bill also stipulates that employers who fail to make the monthly contributions will be liable upon conviction to a fine not exceeding 50 currency points an equivalent of 1 million Uganda Shillings, whereas the self-employed who fail will be compelled to pay five times the fee.
However, Kiwanuka predicts problems in having employers comply. She said already employers are not comfortable paying NSSF, PAYE and other deductions. She notes that even the government as an employer who may be able to afford 1 per cent, does not pay NSSF and other statutory deductions for its employees.
Robinah Kaitiritimba, the Executive Director Uganda Health Consumers Organization told Uganda Radio Network among the proposals being made is of reductions from the NSSF contributions of 1 per cent to go to health.
Currently, Ugandans are experiencing a very high out of pocket expenditure on health, equivalent to 4l per cent of the total expenditure on health as private health insurance schemes only 1 per cent to 2 per cent of the population, are risk-rated and the premium depends on age and existing health conditions.
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