It is well noted that the President of the Republic of Ghana, His Excellency John Dramani Mahama in his policy statement delivered on the 4th of September 2012, indicated that he had instructed the Minister of Health to coordinate with the various departments and agencies within the sector as far as the NHIS was concerned to undertake several activities among them;

a. Present to him, that very month, a list of additional sources of funding for the NHIS
b. Hasten the preparation towards the nationwide rollout of the Capitation programme of the NHIS
c. Engage critical stakeholders for an open consideration of options for the long term sustainability of the NHIS including discussions of the One-Time Premium.

It is again worthy of note that following the above, a stakeholder?s conference was held at La Palm Royal Beach on the 20th and 21st December 2012. The theme of the conference was ?Re-engineering the Financial Architecture of the NHIS?. The stakeholders reached several conclusions including the following:

1. Given the evidence currently available to stakeholders, it was the opinion that the implementation of the One-Time Premium policy would be ill ?advise.

2. That, there should be an upward adjustment of the Value Added Tax (VAT) component of the funding source of the NHIS from 2.5% to at least 3.5%.

It comes out clear, that for the national rollout of the Capitation Programme of the NHIA, currently being practiced in the Ashanti, not much has been heard.

The NHIA has been very emphatic that the Capitation Programme of the NHIA introduced in the Ashanti was a pilot programme to be implemented for a one-year period after which it would be rollout nationwide. The one year period ended in December 2012.

ADU wishes to remind His Excellence the President, that in his policy statement last September, he stated that he had instructed the Minister of Health to ?Hasten the preparation towards the nationwide rollout of the Capitation programme of the NHIS?, and also remind the NHIA that the one year for the pilot was over.

Now the questions ADU seek to ask are;

i. What is presently being done about the capitation?
ii. What came out of the His Excellency?s directive?
Whiles the stakeholders? conference did not discuss nor came out with issues concerning the capitation policy, ADU is yet to hear about any intended discussions on the subject matter. The question is why the silence? What is the way forward for capitation in the Ashanti Region, while the people of the region suffer from substandard service provision?
What pertains presently in the region are;
A. Cash and carry system continues to prevail
B. Clients are under served and under provided
C. Most private hospitals still do not accept capitation
D. Stakeholders frown on Capitation
E. Patients continue to suffer and are disoriented

Indeed several questions beg for answers;

1. Was there a need to consider the much espoused One-Time premium when issues about capitation are still pending?

2. Will there be a justification for an upward adjustment of the Value Added Tax (VAT) to fund the NHIS if a whole region is not benefitting from the NHIS?

3. Where lies the justification for the reorganization of the NHIS without considering Capitation affection about six million people in the region?

Certainly, these questions need answers from the highest office in the land, and the NHIA.

Thank you.

Edmond Oppong-Peprah


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