Written by David Tash Lumu
Thursday, 23 April 2009 17:32
Uganda's health system is a patient that the government continues to give an under dose, says Dr. Sandra Kiapi
Dr. Ian Clarke, the proprietor of International Hospital Kampala, has blasted government’s plan to hurriedly roll out the not-so-popular Health Insurance Scheme, arguing that it will result in “disappointed” expectations.
Speaking during a public dialogue on the proposed social health scheme organised by Platform For Labour Action, at Hotel Equatoria, Dr. Clarke said that in a country where corruption has been accepted as a way of life, rushing the scheme would be a waste of time.
“Insurance is not something magical. Government must address all the issues involved in the scheme. Narrow tax base, corruption, cost of doing business, global recession, increase in the cost of employment, and Uganda’s growth rate falling,” he said.
“Planning is lacking; government is pushing the bill without a clear policy on details. It will result in disappointed expectations,” he added.
Cabinet recently passed a resolution to introduce a compulsory national health insurance scheme beginning later this year. The scheme hopes to reduce the cost of medical treatment at individual level.
However, civil society organisations and other stakeholders warn that the scheme doesn’t address social protection goals of getting into the informal sector—where over 80% of Ugandans belong.
“The health system in Uganda is a patient that government continues to give an under-dose in terms of funding. It lacks facilities, drugs and infrastructure—and this scheme only targets those who are working—eliminating the poor who are the majority,” said Sandra Kiapi, Executive Director of Action for Health, Human rights and HIV\AIDS (AGHA).
Participants who rejected the scheme argued that it might turn predatory on the workers’ meagre earnings. They advised the government to drop it immediately.
“It’s a non-starter. A good thing not put in the right framework. A copy and paste issue which doesn’t resonate with reality. A design to encroach on the poor salaries of Ugandan,” said one participant.
The participants called on government to “get back to the drawing board” and first cure the “rotten health administration” and “sick health centres” before venturing into what it can’t “chew”.
“What government needs to do is to first ensure that jobs are available for all Ugandans, load hospitals with drugs, and pay well the doctors, then begin to talk about health insurance,” said Vincent Nuwagaba, a human rights activist.
The Commissioner of Health Services and Planning, Dr. Francis Runumi, however, said that the scheme is well-designed with one of the positive spin-offs being; sharing the burden of the cost of health which is too heavy for individuals.
“Practical measures to ensure the provision of basic medical services to the population are needed in this country. And I must say, only those who pay towards this fund will benefit. Let the unfortunate get NGOs or government to pay for them because if we cater for all people, the fund will be drained and it will not work,” he said.
Admitting the Ministry of Health’s manpower quagmire, Runumi lamented that this year the ministry advertised for 120 jobs for doctors but only 41 applied. Of the 41, only 21 turned up for interviews. “And after the interview, 11 reported for work—something that is shocking. Doctors are frustrated because of under-funding,” he said.
In fact, Runumi said, the scheme might be delayed to enable government address some of the issues raised by the participants.
On the other hand, Dr. Clarke advised the government to utilise the proposed NSSF medical fund instead.
“NSSF has not been given consideration—yet its proposal to allocate part of their budget to health insurance can be fully shaped at no extra cost,” he said.
The National Social Security Fund (NSSF) is working on a parallel health insurance scheme which is being fast-tracked for all its members. The NSSF scheme proposes health insurance for members funded by their contributions.
The health insurance bill which will actualise the scheme when enacted, proposes a consolidated and comprehensive social protection policy, whereby taxpayers in the formal sector contribute 4% of their gross salary earnings for health insurance. Workers already pay 30% of their salary as P.A.Y.E while 5% goes to NSSF.
Kenya, Rwanda and Nigeria are some of the African countries with similar healthcare schemes.
dtlumu@observer.ugThis e-mail address is being protected from spambots. You need JavaScript enabled to view it
No comments:
Post a Comment