Comply with NHI Act to prevent further collapse – Minority to Gov’t

The Minority in Parliament led by the ranking member on the parliamentary select committee on health and member of parliament for Juaboso, Kwabena Mintah Akandoh has called on the government and the Minister of Finance to strictly adhere to provisions of the National Health Insurance Act (Act 852) to keep the scheme running.

According to the minority, the scheme is in serious crisis due to neglect and lack of funds from the Ministry of Finance for the past three (3) months.

Prior to the minority’s call, the CEO of the scheme, Dr. Dacosta Aboagye disclosed that the NHIA is not bankrupt adding that it pays out between GH₵180 million and GH₵250 million monthly hence the scheme is in a robust financial position.

However, the minority in its statement noted that, “How can the NHIA be in robust financial position if it had not received any releases since 28th of February 2024?

The caucus further noted that, “In fact, the NHIA is bankrupt because it has not received any releases from the Ministry of Finance this year. In addition, our checks at the Bank of Ghana show that the National Health Insurance Fund has less than GH₵1.0million. This a fund that is bankrupt, to say the least”.

It is therefore urging the Bawumia-led Economic Management Team to direct the Minister responsible for Finance to release and transfer all outstanding payments to the National Health Insurance Fund by the close of the week to prevent the scheme from being imperilled due to lack of funds and that the minister must fully comply with the provisions of the National Health Insurance Act (Act 852), as non-compliance has clear consequences outlined in the Act.

Read full statement Below

RELEASE EXPENDITIOUSLY NHIL RECEIPTS INTO THE NATIONAL HEALTH INSURANCE FUND TO RESOLVE ITS CURRENT BANKRUPT FINANCIAL POSITION, PAY OUTSTANDING ARREARS AND COMPLY WITH THE NATIONAL HEALTH INSURANCE ACT.
Accra, [24/05/2024] –

The Minority in Parliament is outraged by the blatant disregard for the sustenance of the National Health Insurance Scheme by the Akufo-Addo-Bawumia-led administration which has resulted in its current bankrupt financial position. This gross and wanton neglect has driven the National Health Insurance Scheme (NHIS) into a precarious financial state of comatose requiring intensive care services to save it from impending and inevitable collapse.

In an interview granted this morning by the Chief Executive Officer of the National Health Insurance Authority (NHIA), Dr Dacosta Aboagye, on JoyNews’ AM show, he stated that since his appointment, “we are still waiting for them [Ministry of Finance] to do releases” to the authority.

This is quite worrying considering the fact that in that same interview he kept saying that the NHIA was in a robust financial position. How can the NHIA be in robust financial position if it had not received any releases since his appointment on the 28th of February 2024?

In fact, the NHIA is bankrupt because it has not received any releases from the Ministry of Finance this year. In addition, our checks at the Bank of Ghana shows that the National Health Insurance Fund has less than GHS1.0million. This a fund that is bankrupt to say the least.

Although the members of the Bawumia-led Economic Management team while in opposition made several promises to improve on the National Health Insurance Scheme, they have at every turn put impediments previously unknown to the scheme since they assumed the reins of power.

The first major blow to hit the NHIS was the sponsoring of the Earmarked Funds Capping and Realignment Act in 2017 by the Akufo-Addo Cabinet. This statute allowed them to operationalize their ulterior motive of diverting critical funds meant for the NHIS into the consolidated fund for projects and programs not approved by Parliament, like the National Cathedral Project, which has now become the most expensive hole in the world.

The operation of the Earmarked Funds Capping and Realignment Act has denied the National Health Insurance Fund (NHIF) payments of over GHS6.0billion. These payments could have gone a long way to improve on the health of the fund and help expand its services to critical treatments like dialysis and cancer care, which currently are not covered by the scheme.
Also, according to the National Health Insurance Act (Act 852), Section 52(1), “The Minister responsible for Finance shall, within thirty days after collection of the levy, cause the levy to be paid directly into the fund and furnish the Minister responsible for Health and the Authority with evidence of the payment.”

However, in flagrant disregard of this statute, the Minister responsible for Finance under the Bawumia-led economic management team places very little priority on the NHIS. While the Ministry collects the National Health Insurance Levy (NHIL) on almost all goods and services monthly as prescribed by law, it habitually delays even the meagre portions it has allocated of these receipts into the National Health Insurance Fund, leading to extended periods during which private health service providers decide not to attend to NHIS cardholders.

In a recent shameless charade to deceive Ghanaians, the Minister of Finance, after five months of not transferring a Cedi to the NHIS, issued a letter directing the Controller and Accountant General to transfer GHS2.4billion to the NHIF. This empty gesture, with no actual intention to make payments, was nothing less than gross official deception and has left the scheme in a state of insolvency.

The underfunding of the scheme has the potential to trigger epidemics such as measles and cerebrospinal meningitis (CSM), as witnessed in the 2022 and 2023, leading to increased morbidity and mortality among the Ghanaian residents. If the current situation persists with the government’s refusal to fund the NHIS, 2024 may see a resurgence of childhood diseases previously eradicated in Ghana. This outcome must be avoided at all costs.
Unfortunately, the management of the National Health Insurance Authority has consistently failed in its fiduciary duty to ensure the viability of the fund. How can a CEO of a fund that has not received a transfer this year be out there granting interviews and claiming the fund is robust if not for the fact that he is a puppet being operated by Bawumia and company?
The NHIA management remained silent when the fund was capped in 2017 for no real logical reason.

Over the years, they have allocated their meagre resources to exorbitant IT projects that have not yielded any real returns for the Scheme.

All these raise probing questions as to whether their primary duty is to protect and support the sustenance and improvement of the scheme or to cater to the political whims and caprices of the Bawumia-led economic management team, even if it means compromising the scheme’s integrity.

These combined factors of capping, zero transfers and a complicit or pliant management has compounded the already precarious financial position of the NHIS and contradicts the Akufo-Addo administration’s previous stance in opposition while exposes the Bawumia-led economic management team’s gross dereliction of attending to the health needs of Ghanaians.

The Bawumia-led economic management team must however take cognisance of the fact that the NHIS relies on the trust that the government will pay claims of subscribers when they fall due. Undermining this trust threatens the very existence of the fund as established by law.

The Minority therefore calls on the Bawumia-led Economic Management Team to direct the Minister responsible for Finance to release and transfer all outstanding payments to the National Health Insurance Fund by close of the week to prevent the scheme from being imperilled due to lack of funds.

Furthermore, we urge the Minister responsible for Finance to fully comply with the provisions of the National Health Insurance Act (Act 852), as non-compliance has clear consequences outlined in the Act.
In conclusion, the Minority assures all Ghanaians that we will not relent in our oversight responsibility of holding this government accountable. Ensuring that the needs of the average Ghanaian are met, including health, in a timely manner according to our statutes is our highest priority.
Thank you and may God bless you.

Kwabena Mintah Akandoh
(MP for Juaboso and Ranking Member on the Parliamentary Select Committee on Health)