CROSS ROADS : New NHIF move will only punish members

Normally, in our community, we go to the hospital because we are sick. It’s rare for us to go there just for routine checkup. Well, it’s something that we need to change. All in all, let’s get back to our talk.

If you are under a health insurance scheme, there is comfort that you’ll get treatment at your designated hospital even when you have no money.

It seems to me, there are times the National Health Insurance Fund (NHIF) behaves as if treatment offered to its members is a favour rather than a right.

On February 26, 2012, I wrote in this column how patients who were visiting a Dar hospital were inconvenienced when the facility had a disagreement with NHIF. At the end of the day, it was patients who suffered.

The Fund is at it again as it made a major decision without consulting adequately with service providers. The Citizen’s Tuesday edition reported how the Fund has drastically reduced its hospital billing rates, cutting the cover on some medical services by 60 per cent. Well, what a shock!

The worst part of this whole episode is that many service providers were caught unaware! Or, so they claim. It pains a lot to take a patient to your usual hospital only to be told that NHIF cards are no longer accepted there unless you can top up the difference!

We all know that public health facilities cannot accommodate all Tanzanians. Even the private hospitals in Dar, most of the time, have long queues meaning their services are in big demand.

In some of the hospitals, you get there only to face an indirect rejection: “Sorry, we have very few beds for people holding NHIF cards. The ones that are there are all occupied.”

With the new development where Association of Private Health Facilities of Tanzania is not happy with the rates, we can expect more hospitals to reject patients holding the cards.

Despite assurances from Health minister Ummy Mwalimu that the new prices can be reviewed after a year, some hospitals may not compromise. Patients who used to go to certain private hospitals will suffer most.

Ms Mwalimu said: “Throughout the world, there are tensions between service providers and health insurance schemes.” Well, does it mean we also want to be in a tension simply because the rest of the world is? After all, it is the member who will suffer the consequences!

There is a price to being a member of NHIF. Monthly contributions are deducted from one’s salary. There are months and months when none of the members’ dependents need medical attention, yet contributions don’t stop. If one cannot fully enjoy the services, then why pay for them?

So far it is mostly people in formal jobs who enjoy the benefits of the Fund. Plans have been to include those in the informal sector as well. But this current move is going to discourage them.

Before Tanzania can gradually introduce universal public health coverage, we should start by making all public hospitals deliver quality and adequate health services.

Looking at the case of Botswana where all citizens are treated in public facilities free of charge for most medical cases, it is apparent that this is possible because 98 per cent of health facilities are run by the government.

In the first phase government, for years health services were provided for free. Today, as much as some services are free for mothers and under-5 children, health care depends on patient’s pocket. Those with insurance schemes like NHIF are better off, only if they can get health services, if not, it is a problem.