Private sector involvement vital for NHI - expert

Cape Town – South Africa should rely on the expertise and strengths of its private healthcare system for a successful rollout of its planned national health insurance (NHI) scheme, according to the former head of Ghana’s national health insurance system.

Nathaniel Otoo, former CEO of the Ghanaian National Health Insurance Authority (NHIA), addressed delegates at the Board of Healthcare Funders’ national conference in Cape Town, sharing some of Ghana’s challenges with implementation of universal healthcare.

Universal healthcare is one of the Millennium Development Goals and countries around the world are currently grappling with the challenge to realise this by 2030.

Otoo stressed the importance of private sector involvement in the quest for universal healthcare in his country.

“The private sector must play a role from the onset, as it is an engine of growth that often excels in innovation, financial management, risk taking and entrepreneurship and customer care.”

He said in implementing universal healthcare in South Africa, the country could effectively leverage these private sector strengths to ensure a successful NHI implementation.

“If well planned and conceived, the private sector could be a reliable partner for regulation, governance, health service provision, quality improvement, financial intermediation, information systems support, commodity supply chains, and most importantly customer care.”

There are still challenges that prevent universal health from being fully implemented in Ghana though, such as the financial sustainability of the model, poor regulation in the health sector, inequitable distribution and poor quality of services.

“With over 200 hospitals in the country, run mostly by the government through the Ministry of Health and the Ghana Health Services, corruption and maladministration in the distribution of funds for expanding and sustaining the NHIS poses a major challenge,” he said.

Otoo said in Ghana, the NHIS was established in response to very limited access to healthcare as a result of a fee payment system called “cash and carry” which came into effect in the 1980s.

“By the early 2000s, only about 20% of the population could access healthcare in Ghana and this was a significant reason for launching the NHIS.”

Ghana has a population of about 27.4 million and the country still has some way to go before achieving universal healthcare, with only 41% of the population currently covered by NHIS.

The discussion on universal healthcare comes as South Africa is embarking on its own NHI implementation. Cabinet recently approved the NHI White Paper and it will soon be gazetted as a national policy document.

The proposed system however faces a number of challenges, such as uncertainty about funding and the future role of medical schemes and private healthcare providers.

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