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.
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Showing posts with label Social security. Show all posts
Showing posts with label Social security. Show all posts
Saturday, May 28, 2011
Saturday, May 21, 2011
NSSF continues to be an enigma in the lives of Uganda’s Workers
This is my article which was published by The Independent on January 15, 2010
The National Social Security Fund (NSSF) has for long remained in the press for wrong reasons. Yet, it continues to intensify its recruitment drive of contributors. While ordinarily social security or social protection is a right enshrined in very many human rights instruments, for the case of NSSF, contributors save with it not because they know NSSF is an institution that would guarantee their right to social protection but they do so because it is mandatory. In fact, while addressing members of National Union of Educational Institutions (NUEI), Makerere University Branch, Mr. Alinda Kimomi, NSSF Area Manager, Kawempe, said the university staff that are saving their money with DAP are infringing the law. I learnt two things; one, the NSSF Management/Staff and government are the biggest beneficiaries of the workers’ savings and two, both government and the NSSF Management/staff now believe that man is meant to serve the law and not the law to serve man. That is why workers are cajoled into registering with NSSF whether or not they like it. I have read the NSSF Act and I find it greatly wanting thus needing thorough overhaul.
Alinda disclosed to the workers that NSSF lost money to Safari Com and that it also lost money to some foreign currency and that the currency also tumbled. The argument he gave was that it was a global trend and the NSSF management had nothing to do about it. He accordingly, called on the NUEI staff to encourage their friends to register with the Fund. Alinda furthermore disclosed that NSSF is very rich because the fund is worth 1.2 trillion. The question then should be: how much does the contributor benefit when this financial year’s interest on the workers’ savings is a paltry 3%.
The NSSF Managers are themselves quite interesting. I say interesting because Alinda frankly told the NUEI members that the law forbids the fund from giving an interest of less than 2.5 percent. That the workers cannot be paid 1% or 0% yet he had already told them before that NSSF is like a business and that if business makes losses the shareholders share the losses and if it makes profits, they share the profits. I surmise that had they been not hindered by the law, the Fund Managers would choose to always declare negative interests arguing that they have incurred losses.
I wish to state categorically clear that the workers have rarely made any profit on their savings because in 2008 when the interest was declared 14% after reportedly making huge profits, the inflation rate was reportedly oscillating between 14 to 16% although the Fund Managers say it was 11%. Assuming the inflation was 11% that is the only year when NSSF contributors made a paltry profit on their saving of 3%. The question then is: if NSSF is a business which it is, whose business is it? Is it for the workers who never make any profit on their savings; is it for the NSSF Managers or is it for the government? Maybe, the NSSF business is a joint venture between workers on one hand and Management and government with the former incurring losses while the latter reaps the profits. More often than not the Fund Managers and the government are inextricably linked for they are often appointed on patronage basis.
The NSSF can convince the contributors – employers and workers that it is a business if it makes profit and the workers benefit from the profit made. Otherwise, it will be difficult to convince many of us that it is a business worth its salt if it has specialized in making losses to the contributors. I am not one of those people that can be confused to think that the Fund doesn’t make profit. Indubitably, it generates profit on the workers’ savings but the Management doesn’t want to disclose it to the workers or it is directed courtesy of powers from above not to disclose the profits and henceforth share them with the contributors.
The National Social Security Fund (NSSF) is one of the richest institutions. This is the explanation that was given at the time the fund management was transferred from the Ministry of Gender, Labour and Social Development (MGLSD) to the Ministry of Finance. The lame argument that was given is that MGLSD had no technical expertise to handle huge sums of money as though the government was barred from hiring experts to handle those huge sums of money. Why NSSF contributors never benefit from those huge sums of money is an enigma.
We have always argued that corruption begets corruption. In July 2008, NSSF recruited huge numbers of staff. But many of those that were recruited had earlier entered through connections and were up to that time working as volunteers. Although many or all of the recruited staff have the requisite credentials, the method of entry is suspect and they can be used to satisfy the interests of those that helped them enter. In any case there are many people out there with the requisite if not better credentials to serve such an institution. I would expect a reputable organisation which claims flowery values to place an advert in the press for every interested person to apply. I have also written about the counterfeit employees that were chased from the organisation whom the former Managing Director David Chandi Jamwa wrote they were going to get their benefits yet they attained jobs illegally using fraudulent documents. I argued that these people should be sent to Luzira instead of giving them more money.
The practical step that can minimize on the NSSF mismanagement and inefficiency is liberalizing the social security scheme to allow many prayers akin to what it is with the Banking sector. If one is disenchanted with Barclays they shift to Centenary and so forth. Ironically, the NSSF Managers and staff are already predicting doom arguing that some unscrupulous investor may run with the workers’ huge sums of money. Why are such fears not raised with the Banks which also collect huge sums of money not only from hundreds of thousands (as is the case with NSSF whose membership is reportedly around 500,000) but from millions of people including workers, the unemployed, students among others? What is sauce for the goose is sauce for the gander. I have a hunch that both the NSSF Management and the government have ulterior motives for opposing the liberalization of the social security scheme and I guess, as we approach 2011, part of the workers’ money handled by NSSF shall be spent in the campaigns to retain the ruling party in government.
Vincent Nuwagaba is a human rights defender and a specialist on socio-economic rights.
The National Social Security Fund (NSSF) has for long remained in the press for wrong reasons. Yet, it continues to intensify its recruitment drive of contributors. While ordinarily social security or social protection is a right enshrined in very many human rights instruments, for the case of NSSF, contributors save with it not because they know NSSF is an institution that would guarantee their right to social protection but they do so because it is mandatory. In fact, while addressing members of National Union of Educational Institutions (NUEI), Makerere University Branch, Mr. Alinda Kimomi, NSSF Area Manager, Kawempe, said the university staff that are saving their money with DAP are infringing the law. I learnt two things; one, the NSSF Management/Staff and government are the biggest beneficiaries of the workers’ savings and two, both government and the NSSF Management/staff now believe that man is meant to serve the law and not the law to serve man. That is why workers are cajoled into registering with NSSF whether or not they like it. I have read the NSSF Act and I find it greatly wanting thus needing thorough overhaul.
Alinda disclosed to the workers that NSSF lost money to Safari Com and that it also lost money to some foreign currency and that the currency also tumbled. The argument he gave was that it was a global trend and the NSSF management had nothing to do about it. He accordingly, called on the NUEI staff to encourage their friends to register with the Fund. Alinda furthermore disclosed that NSSF is very rich because the fund is worth 1.2 trillion. The question then should be: how much does the contributor benefit when this financial year’s interest on the workers’ savings is a paltry 3%.
The NSSF Managers are themselves quite interesting. I say interesting because Alinda frankly told the NUEI members that the law forbids the fund from giving an interest of less than 2.5 percent. That the workers cannot be paid 1% or 0% yet he had already told them before that NSSF is like a business and that if business makes losses the shareholders share the losses and if it makes profits, they share the profits. I surmise that had they been not hindered by the law, the Fund Managers would choose to always declare negative interests arguing that they have incurred losses.
I wish to state categorically clear that the workers have rarely made any profit on their savings because in 2008 when the interest was declared 14% after reportedly making huge profits, the inflation rate was reportedly oscillating between 14 to 16% although the Fund Managers say it was 11%. Assuming the inflation was 11% that is the only year when NSSF contributors made a paltry profit on their saving of 3%. The question then is: if NSSF is a business which it is, whose business is it? Is it for the workers who never make any profit on their savings; is it for the NSSF Managers or is it for the government? Maybe, the NSSF business is a joint venture between workers on one hand and Management and government with the former incurring losses while the latter reaps the profits. More often than not the Fund Managers and the government are inextricably linked for they are often appointed on patronage basis.
The NSSF can convince the contributors – employers and workers that it is a business if it makes profit and the workers benefit from the profit made. Otherwise, it will be difficult to convince many of us that it is a business worth its salt if it has specialized in making losses to the contributors. I am not one of those people that can be confused to think that the Fund doesn’t make profit. Indubitably, it generates profit on the workers’ savings but the Management doesn’t want to disclose it to the workers or it is directed courtesy of powers from above not to disclose the profits and henceforth share them with the contributors.
The National Social Security Fund (NSSF) is one of the richest institutions. This is the explanation that was given at the time the fund management was transferred from the Ministry of Gender, Labour and Social Development (MGLSD) to the Ministry of Finance. The lame argument that was given is that MGLSD had no technical expertise to handle huge sums of money as though the government was barred from hiring experts to handle those huge sums of money. Why NSSF contributors never benefit from those huge sums of money is an enigma.
We have always argued that corruption begets corruption. In July 2008, NSSF recruited huge numbers of staff. But many of those that were recruited had earlier entered through connections and were up to that time working as volunteers. Although many or all of the recruited staff have the requisite credentials, the method of entry is suspect and they can be used to satisfy the interests of those that helped them enter. In any case there are many people out there with the requisite if not better credentials to serve such an institution. I would expect a reputable organisation which claims flowery values to place an advert in the press for every interested person to apply. I have also written about the counterfeit employees that were chased from the organisation whom the former Managing Director David Chandi Jamwa wrote they were going to get their benefits yet they attained jobs illegally using fraudulent documents. I argued that these people should be sent to Luzira instead of giving them more money.
The practical step that can minimize on the NSSF mismanagement and inefficiency is liberalizing the social security scheme to allow many prayers akin to what it is with the Banking sector. If one is disenchanted with Barclays they shift to Centenary and so forth. Ironically, the NSSF Managers and staff are already predicting doom arguing that some unscrupulous investor may run with the workers’ huge sums of money. Why are such fears not raised with the Banks which also collect huge sums of money not only from hundreds of thousands (as is the case with NSSF whose membership is reportedly around 500,000) but from millions of people including workers, the unemployed, students among others? What is sauce for the goose is sauce for the gander. I have a hunch that both the NSSF Management and the government have ulterior motives for opposing the liberalization of the social security scheme and I guess, as we approach 2011, part of the workers’ money handled by NSSF shall be spent in the campaigns to retain the ruling party in government.
Vincent Nuwagaba is a human rights defender and a specialist on socio-economic rights.
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