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NATIONAL HEALTH INSURANCE AUTHORITY. PRESENTATION AT THE DONOR FORUM ON WORLD BANK GROUP PARTERNSHIP, PROGRAMS AND TRUST FUNDS PARIS, FRANCE MAY 20-21, 2008 BY RAS A. BOATENG (CHIEF EXECUTIVE). Outline Of Presentation. Overview of Health Insurance Act Private Sector Participation

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NATIONAL HEALTH INSURANCE AUTHORITY

PRESENTATIONAT THE DONOR FORUM ON WORLD BANK GROUP PARTERNSHIP, PROGRAMS AND TRUST FUNDS

PARIS, FRANCE

MAY 20-21, 2008

BY

RAS A. BOATENG

(CHIEF EXECUTIVE)

outline of presentation
Outline Of Presentation
  • Overview of Health Insurance Act
  • Private Sector Participation
  • Status of Implementation
  • Challenges
  • Strategies to address challenges
overview of health insurance act
ACT 650

NATIONAL HEALTH INSURANCE COUNCIL

TYPES OF HEALTH INSURANCE SCHEMES

NATIONAL HEALTH INSURANCE FUND

Implement NHI Policy

Subsidize Cost to DMHIS

Establishment of District Mutual Health Insurance

Education Programs

Register, license & Regulate HIS

Reinsure DMHIS against cost fluctuations

Establishment of Private Commercial Health Insurance

Grant accreditation to Healthcare Providers

Fund Indigent Healthcare cost

Determine Premiums

Establishment of Private Mutual Health Insurance

Provide access to health service

Manage NHI Fund

Promote Health Education

Overview Of Health Insurance Act
private sector contribution to the growth of health insurance in ghana
Private Sector Contribution to the growth of Health Insurance in Ghana
  • 1993: Nationwide Mutual Medical Insurance Scheme (by the Private Medical Practitioners Association; reached subscriber base of 20,000 people in 2 years, corporate subscribers paid premia annually, half yearly or quarterly and was based on the benefits level)
  • 1997: Metropolitan Health Insurance Plan (by Metropolitan Insurance company Ltd., As at September 2001, 15,000 subscribers were on full cover, 25,000 on partial cover. Over 100 companies had subscribed. Had designed a package for the educational sector workers and was working with Defence to design one for the Civilian workers/dependants of the Military)
  • 1999: The Ghana Healthcare Company (by SSNIT but still at gestation period)
  • The Nkoranza Community based Mutual Health Scheme
private sector participation in nhis implementation financing side
Private Sector Participation in NHIS Implementation (Financing side)
  • Gemini Life Insurance Company
  • Vanguard Assurance
  • Momentum Health Insurance
challenges of the private sector in health
Challenges of the Private Sector in Health

Private Health Insurance side:

initial capitalisation, e.g. the security deposit

Private Provider side:

disincentive in locating at hard to reach areas

Initial capitalisation

Technical Personnel

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Incentivise private providers to operate in hard to reach areas.

Use of accreditation of existing private providers to redistribute health facilities to improve geographical access

Encouraging Ghanaian doctors/Nurses in Diaspora to relocate and establish modern health facilities in the country through the franchise idea

Proposed strategies to address challenges

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