Need to embrace health insurance scheme

KOJO's DIARY: Accra Beat
When the government fulfilled its election promise and started to implement the National Health Insurance Scheme (NHIS) many were those who were and still are sceptical about the effectiveness of such a health care financing policy.
Many people, especially those who belonged to the other side of the political divide, held the perception and resolutely prayed that come what may, the programme will not succeed and should not. Other people who could easily pass off as enlightened because of their level of schooling and who should have done everything to embrace such a laudable initiative were reluctant to join.
During the Christmas break, I engaged a female friend of mine in a lengthy discussion at the back of a street spot in Accra and she passed vain comments about the NHIS. In fact, to her, she did not see how she could be convinced to join such a bogus scheme.
I was shocked to the marrow because she kept giving me the indication that either she had refused to be educated on the scheme or she was flatly giving a dog a bad name?
According to her the scheme was a waste of money because she was someone who did not attend hospital and since throughout the year she might not even fall sick to warrant her visiting the hospital, registering for the scheme was irrelevant.
All her excuses were based on flimsy hearsay and she was explicit that each time she fell sick her first port of call was to go to the pharmacy shop. Maybe, she could be understood because the hospital or clinic had not been able to diagnose her sickness which she believed could be a bout of malaria. But is that expedient?
I then informed her of my experience in the village where my mother, a stark illiterate, who had registered with the scheme expressed her joy at its effectiveness.
You know what? Prior to the implementation of the scheme, the old lady who is hypertensive could not afford to buy even very cheap drugs prescribed for her. Each time that a drug I considered to be less expensive was prescribed for her, she will rush the prescription form to me in Accra and have the drugs purchased for her.
On my visit to the village sometime before the Christmas she elatedly told me, “Kwadwo, now I feel fine. I am now okay and each time I am going for a review all I need is my Taxi fare because I need not purchase any drugs for my ailment”.
When I asked her what her secret was, feigning ignorance of her NHIS status, she replied that because of the scheme, the health officials ( obviously some nurses) had confided in her that the doctors now prescribe the best of medicines for her, which hitherto, she could not have afforded.
So I told my friend about my encounter with the old lady and the need for every Ghanaian to embrace the scheme in 2007. Readily, she agreed and gave me a new year resolution that she would register in 2007 because she did not know much about the NHIS. Even with my ‘little’ knowledge I have been able to win one soul for the scheme so what is needed is education.
What people like my friend however forget is that even with the slightest headache one could spend more at a pharmacy or chemical shop than what is paid for the scheme annually.
Besides, the individual contributions to the scheme make it a pool and for which reason even if one did not visit the hospital for obvious reasons, others, especially the less privileged ones stand to benefit from it. That way, many souls could be saved. Therefore, we should not only think about ourselves but the rest of the society.
Those who still believe in the cash and carry system or any other health financing scheme, should realise that times are changing and we need to keep pace with the changing times. Imagine you getting involved in a freak accident or suddenly falling sick which demand an impromptu visit to the hospital? Its shortcomings notwithstanding, with the current dispensation, one can be saved since no down payment will be made.
This is not to say that the scheme is 100 per cent efficient. No. As a human institution, there are bound to be problems but they are surmountable.
There is no doubt that the scheme might have started off very badly in many areas but all the same we should all embrace it and pray that it works out well.This is incumbent on both the personnel in whose hands the scheme has been entrusted and the contributors. The health care personnel should not let us reminisce over the bad practices which were associated with the cash and carry system where some health facilities corrupted the scheme.
There were instances when some of them did not spend a dime on the exemptions category yet they provided very fat claims to that effect and the proceeds ended up in individual pockets.
Ghana is noted for engaging in unnecessary complacent self-congratulation but recent media reports about the detention of patients by some health institutions for non-settlement of bills makes mockery of our situation and efforts towards national productivity.
Productivity of labour depends on the state of health of a nation since an efficient health care delivery system has tremendous economic value and plays very crucial role in the country’s development prospects.
Some gains seem to have been chalked up in Ghana’s health care delivery system, however, in spite of these persistent efforts by both the past and present government basic health indicators show that the health status of Ghanaians remain relatively poor with life expectancy still low, coupled with the high incidence of infectious diseases and high maternal and infant mortality rates, among other emerging diseases such as buruli ulcer.
The situation is of serious concern , especially when the majority of Ghanaians are poor. This is imperative in view of the fact that the WHO has reported that the problem of health care on the poor sectors of a population is heavy.
Health and poverty, according to the Global Forum for Health, are inextricably linked and that poverty is often associated with ill-health.
I have said that we should not engage in any unnecessary complacent self-congratulation as far as the NHIS is concerned because certain variables will hamper its progress. The pluralistic nature of medical care, namely, home remedy (self medication), the resort to traditional medicine vis-à-vis orthodox medical care greatly influence health utilisation.
Also associated with the above is a number of discrete but interrelated variables such as the location, cost, quality, transport and education.
Moreover, perception is a key concept as far as health utilisation is concerned. This is because people share similar beliefs, attitudes and values with others who are members of the same community, which is why when people are sick various descriptions and prescriptions are made, ultimately not making one to seek medical attention at the hospital.
Peoples perception and belief about the efficacy of both traditional medicine and western medicine make them resort to the use of either of the two, and our economy which is predominantly rural, tends to favour the use of traditional medicine. It is not for nothing that one often hears some Ghanaians remark that they were not properly treated when they visited the hospital. This is because their expectations had not been met. Some of them expected to be injected or given a certain kind of medication and if that fails, then to them attending the hospital did not pay off.
It is never too late to do what had not been done in terms of education. And since groups have greater influence on the behaviour of people, avenues should be sought to educate the people using the churches, mosques and even the hospital setting and the medium of the media, particularly radio and television.
We need to do this in order to bridge the unequal distribution of health care facilities which tilt in favour of the urban and southern sectors of the country because the majority of our people are still in the wilderness as far as the NHIS is concerned.
It is lso important that everything should be done to speed up the process, especially in the case of workers whose social securities have been used to offset cost yet it has taken them more than a year for them to receive their NHIS registration cards.
The scheme is of tremendous importance to our people and nobody should be left out. Had I known, it is often said, is always at last.