For the poor majority, the allure of a new legislation that guarantees all-round medical cover offers them hope of treatment from “potentially survivable” ailments.
In a presser at the Uganda Media Centre yesterday, government unveiled plans of introducing two new bills; the National Health Insurance Scheme (NHIS) bill and the National Payment Systems bill, 2019.
Dr Sarah Byakika, the commissioner for Policy, Finance and Planning in the ministry of Health, and Ali Walimbwa, a senior planner in the same ministry presented the NHIS bill to the public. They said the health insurance will cover all residents of Uganda to ensure a healthy population by 2040.
Byakika revealed that government was nudged to act by the skyrocketing number of deaths at health facilities all over the country caused by manageable health conditions. If the bill is passed, Ugandans will not necessarily move with physical cash to hospitals but, rather, insurance cards issued by the NHIS.
“Government will, however, cater for only specific health conditions, not all,” Byakika said when asked whether the bill would cater for expensive illnesses like cancer.
In one of the key objectives, the health insurance scheme will ensure equity and appropriate utilisation of health services. It will also be a mechanism for financing health care in Uganda because it will minimise reliance on foreign donations and grants to the health sector. NHIS costs for the start will be met by all Ugandans aged 18 and above while children will be covered by their parents or guardians.
NHIS in depth
The National Health Insurance Scheme (NHIS) Bill dates back to April, 7, 2017 when it was first presented to the ministry of Finance, Planning and Economic Development for approval. It had been projected to start in the financial year 2017/18.
According to the ingredients of the bill, government and private employees will contribute four percent of their monthly salary to the NHIS while employers will contribute one percent of each employee’s salary.
Self-employed individuals in the informal sector will pay Shs 100,000 per year while pensioners will contribute one percent of their monthly pension payment. The bill further exempts indigents (people below the poverty line) from contributing as their coverage is subsidised by other members of the scheme. It will take 10 years for all indigents to be covered as only 10 percent will be enrolled every year.
Government will continue to fund the provision of free health services in health facilities till every Ugandan is enrolled in the NHIS. It will also continue funding public health interventions and other specialised services outside the standard benefits package and other health investments such as major infrastructure, human resources, specialised medicines and technology at a reducing scale as a means of contributing to the growth of the NHIS.
The NHIS will be composed of three sub-schemes, which will include Social Health Insurance (SHI); Community Based Health Insurance (CBHI), which will mainly target the informal sector and lastly, the Private Commercial Health Insurance(PHCI).
It is projected that government will need Shs 3bn to start up awareness creation campaigns, developing regulations and institutional framework, among others.
Another Additional Bill passed
The government spokesperson, Ofwono Opondo also added another bill where government plans to monitor and regulate the electronic commercial transactions. ‘’Since its introduction 10 years back, mobile money remains unregulated.
When a person dies with his or her secret pin code, what happens to the money? Where does it go?” Opondo asked as he unfolded the new bill.
The National Payment Systems Bill, 2019 is one of the cabinet resolutions that await parliamentary approval. The bill will monitor inter-institutional payments between commercial banks and the central bank, water bills from citizens to National Water and Sewerage Corporation, Umeme bills, among others.
According to Opondo, through this bill, government is simply coming in to ensure that national circulation of money in commercial transactions is secure and redeemable. The law will, therefore, keenly focus on both individual and commercial transactions.