The government is considering including the cost of dialysis in the National Health Insurance Scheme (NHIS), Minister for Health Kwaku Agyemang Manu has disclosed.
He revealed this on the floor of Parliament on Thursday, November 9, 2023, when briefing the House on the issues surrounding the closure of the Renal Unit at the Korle-Bu Teaching Hospital.
According to the Minister, including dialysis in the Health Insurance Scheme was one of the options the government was contemplating, including increasing the rate and granting subsidies.
“To forestall the recurrence of this unfortunate situation, the ministry, in collaboration with Korle-Bu and the Ministry of Finance, is considering one of the following options: the possible inclusion of dialysis on the National Health Insurance benefit package; the granting of subsidies based on proposals received from Korle-Bu; a possible review of tariffs to ensure the sustainability of the services,” he said, adding that the decision would be announced as soon as practicable.
DEBT
The Minister for Health informed the House that Korle-Bu had accrued a total debt of a “little over GH¢4 million” to its supplier.
He attributed this to the delay in payment by First Sky Groups, a private indigenous company, which had committed to paying GH¢1 million every quarter for five years now.
He added that due to the delay, the unit “continues to accrue exchange rate losses, which has made it difficult for the RDU to service the monthly payment to the partner.” There are 230 patients on the free dialysis program, sponsored by the company.
He explained that the amount accounted for about 80% of the revenue of the Renal Unit, whose main revenue stream had been the payment at a subsidised rate of GH¢380 per session.
The gesture of the company enables patients who could not afford dialysis to have the session twice a week.
The Minister, however, “thanked the Sky Groups once again for this philanthropic gesture, which has supported Korle-Bu and patients for the last six years.”
ISSUES
The Minister for Health emphasizes that the current rate for dialysis is insufficient to enable the unit to generate enough revenue to fulfill its full obligations to the partners.
He also observed that the surge in patients requiring dialysis had increased the total cost of care, adding to the accumulation of debt.
WAYFORWARD
According to the minister, the hospital, collaborating with the ministry, had initiated discussions with its partner for a review of the current contract.
The review seeks a more flexible payment option, among other things, to ensure delivery of the outstanding 45 dialysis machines and auxiliary equipment to boost service being rendered.
In the meantime, he indicated that the dialysis outpatient unit at Korle-Bu, which was closed due to debt, had been reopened since Monday this week.
The Ministry of Health made a request to the Ministry of Finance to settle the GH₡4 million debt, and the Minister for Health informed Parliament that Ken Ofori-Atta had approved the disbursement.
COMMENTS
The Member of Parliament for Asawase, Mubarak Mohammed Muntaka, commenting on the statement by the Minister of Health, described the closure of the Renal Dialysis Unit as “too unfortunate.”
As a member of the Health Committee of Parliament, he observed that the contract with the South African company that supplies consumables and equipment is the start of the “problem of Korle-Bu.”
He explained the problem to be that per the contract, it was only the company that would provide the equipment and its consumables, whereas other contracts could separate it.
“Even though we have not seen the contract, the information we have is that the machine was given for free. So, meaning that the consumables are priced above the open market,” he said.
He argued that Komfo Anokye Teaching Hospital and Berekum Catholic Hospital are operating with the same fees and charges but are still operating.
He therefore refuted the argument that the fees should be adjusted upwards, stating that if they increased, by a year’s time, the problem would resurface because of the exchange rate.
As such, he was happy that the minister told Parliament that discussions had commenced to review the contract.
Though members did not downplay the inclusion of the cost of dialysis in national health insurance, they argued against capping the funds for the scheme by the government.
Members indicated that there was a need to ensure that the scheme got its full budgetary allocation, especially when it was considering adding the cost of dialysis.
The Member of Parliament for Sefwi Wiawso, Dr. Kweku Afriyie, said that capping the national health insurance scheme “is unconscionable. In fact, it is immoral.”
He explained that money taken from the taxpayer is regressive in nature; the best place to put it is with health care financing. “So, why do you take money from health to support budget? I don’t get it.”
