Experts Advise Rethink of National Health Insurance Scheme in Uganda

Health experts have warned that the government could encounter challenges in implementing the redesigned National Health Insurance scheme.

Dr. Freddie Ssengooba, a Professor of Health Economics and Health Systems Management expressed worries that the scheme is being marketed as a magic pill that will sort Uganda’s health challenges immediately after approval, and yet, in reality, reaping benefits from it could take up to twenty years.

He was speaking shortly after after Secretary to the Treasury, Ramadhan Goobi, revealed the government is repackaging the scheme to suit the local context.

The law introducing the scheme hit a snag in 2021 when the National Health Insurance Bill was withdrawn by the government. A revised version has since been stuck at the Cabinet level.

Dr. Sengooba predicts that the cost of administering the planned scheme is likely to be around sixty percent of the collections and that this needs to be discussed fully to find options which will cover those costs.

Goobi says about five percent of Ugandans are currently privately health insured either through corporate plans, individuals, or under community-based schemes, and that they have now gone ahead to come up with well-designed community schemes which suit Uganda, with the majority of the population being in the informal sector.

Further, Goobi revealed they plan to deploy a digital system that will assist them in running the scheme and keep track of users’ medical records.  

Health advocates have been pushing for the national scheme for more than fifteen years, the technocrat says, and having this insurance will be a sure way of cutting the current catastrophic health expenditure that keeps pushing Ugandans into poverty.

Dr. Sengooba predicts that the cost of administering the planned scheme is likely to be around sixty percent of the collections and that this needs to be discussed fully to find options which will cover those costs.

He also says people need to be informed all through to avoid scenarios of subscribers dropping off soon after signing up.  

Even now, where people are enrolled under a voluntary private insurance arrangement, Ssengooba said hospitals are literally shunning insured patients.  

He says that often companies refuse to pay for certain services, and yet their payments also come in late.

Dr Ian Clarke, who was one of the earliest providers of private health insurance in the country, says the number of individuals on private insurance cover is around two percent of the population, lower than the five percent that the government estimates.

He suggests the need to encourage more people to enroll in private schemes, saying the growing middle class is ready to pay if they are given a reason to.