BALANCING INCOME WITH COST: AN ASSESSMENT OF THE FINANCIAL SUSTAINABILITY OF GHANA'S HEALTH INSURANCE SCHEME - A STUDY IN TAMALE METROPOLIS

Abstract

There is considerable interest at present in exploring the potential of social health insurance to increase access to and affordability of health care in Africa. A number of countries are currently experimenting with different approaches. Ghana's National Health Insurance Scheme (NHIS) was passed into law in 2003 but fully implemented from late 2004. This research sought to undertake a critical comparative study of the income and the cost of operating Mutual Health Insurance Schemes in Ghana and its implication on the financial sustainability of the schemes. The study employed both qualitative and quantitative methods of data collection. In this, both primary and secondary data were employed as a means of sourcing information. The study revealed that there is an imbalance between expenditure and revenue which threatens financial sustainability of the schemes. The study equally found that people have taken a stand that "no premiums rise, no benefits reduction and the government has a duty to maintain the NHIS". Despite the fact that the public gave an absolute answer to reject any possible proposals of premium rise benefit package reduction; experience shows that financial sustainability and health coverage and quality is a trade-off issue and all possible reform has to mobilise public opinion and support because it touches everyone's life. The study recommended among other things that the Scheme accepts and encourages installment payment of premium so that non salary workers and the perceived poor would be in the position to join the scheme and honour their financial obligations without any decipherable burden, NHIA should release funds early and regularly to the schemes, there should be intensive education of residents on the health insurance concept through Radio/TV announcements and effective collaboration with the religious bodies in activities such as one-on-one talks, dramas and community durbars.