Africa-Press – Uganda. Although the idea of a National Health Insurance Scheme (NHIS) sounds like one answer to Uganda’s countless health sector problems, promoters of that goal face an uphill climb in actualising it.
Long overdue given the extremely high cost of healthcare today, the proposed scheme would be a welcome respite. However, serious questions stand in its way. For one, how does the government plan to enforce compliance of mandatory contributions? Will the violent methods used by collectors of the discredited and long abandoned graduated tax be reintroduced?
Who will be the scheme’s custodian, and will this insurance be available in only public hospitals? Remember, the appalling services in government medical facilities is the reason extortionate private health care thrives in Uganda. More importantly, how shall we get Ugandans to embrace universal health insurance in an environment where corruption festers in just about every public service?
Most Ugandans no longer trust this government with money. The money pool we are looking at if Cabinet approves the policy would tantalise the thieves who prowl the dark corridors of government. The public would therefore want to know how this government, given its hopeless track record in fighting graft, plans to guard against the very likely theft of their money.
Under a draft policy headed for Cabinet, the proposal is that every Ugandan aged 18 and over will be compelled to contribute to the scheme. Word is that an annual payment of Shs15,000 is being considered as the contributory amount, which comes to about Shs1,250 monthly. Figure looks small when looked at individually but that perspective can be deceptively persuasive.
Looked at as a whole, we are potentially looking at a significant amount of cash under a national health insurance scheme of any description. Public apprehension about its safety cannot be emphasised enough.
Official statistics showed in 2021 that of Uganda’s 45.9 million population then, just under 53 percent lay within the target age bracket. Which means a minimum of 25 million Ugandans will be expected to pay their bit. A quick computation brings the anticipated insurance pool to a very tempting Shs375 billion each year. That money shall grow exponentially because contributors will not lodge insurance claims at once.
In examining the public confidence question, we must reflect on the intractable problem of embezzlement and abuse of workers’ savings at the National Social Security Fund. The NSSF is a semi-compulsory contributory scheme not unlike what is being considered for the NHIS. Political interference has become the regrettable norm at the Fund whose Shs20 trillion kitty is forever being targeted by corrupt managers and other shady characters in cahoots with their political allies in very high places.
Seen in that light, the prospects for public buy-in into this otherwise good idea do not look too bright.
For More News And Analysis About Uganda Follow Africa-Press
