Dispute on new health insurance package drags on as team defends NHIF

Dar es Salaam. The committee tasked with reviewing the new health package benefits has sided with the National Health Insurance Fund (NHIF) in its dispute with the Association of Private Health Sector Facilities Tanzania (APHFTA).

The committee yesterday emphasised the importance of continuing with the implementation of the new arrangement.

It said enhancements to the new health package were achieved through collaboration among all stakeholders after extensive deliberations and, consequently, services must proceed without interruption.

“I would like to reassure Tanzanians that NHIF services will continue as usual because health facilities are contracted with NHIF, not APHFTA. Any alterations would constitute an arbitrary breach of contract,” said committee chairperson Baghayo Saqware.

Dr Saqware, who is also the Commissioner for Insurance, was addressing a news conference in Dar es Salaam following a public notice issued by APHFTA on Wednesday.

APHFTA expressed its intention to suspend services to NHIF beneficiaries in protest at the new health insurance package provided by NHIF.

However, Dr Saqware affirmed that every step regarding the costs and benefits analysis of medicines and treatment was conducted scientifically with the involvement of experts, including association members.

“It is inaccurate to claim that they were sidelined. The committee remains open to further discussions and deliberations if there are alternative arguments, as we all share the common goal of improving the quality of healthcare services in the country,” he said.

“No one is averse to constructive discussions. Therefore, the provision of health services to NHIF beneficiaries will continue through the newly improved package.”

Dr Saqware urged citizens to report health facilities that will halt services for NHIF members for so that appropriate actions can be taken.

He also clarified that NHIF’s contracts with health facilities were transparent, emphasising that no notification had been received from healthcare service providers regarding the intention to suspend services.

Dr Saqware’s statement came after NHIF announced improvements to the health benefits package scheduled to take effect today (March 1, 2024), signalling approval for the Ministry, through NHIF, to proceed with implementing the enhanced benefits package.

The committee, formed by Health minister Ummy Mwalimu, aims to provide advice on various professional issues, particularly on the optimal preparation and implementation of an improved benefit package.

APHFTA national chairperson Egina Makwabe reiterated the association’s position, stating that health services would be suspended after 48 hours, effective from midnight on today to allow the government to address their grievances.

He argued that the introduced improvements showed no significant difference from the previous ones, citing, for instance, that the reduction in the cost of a C-Section from Sh500,000 to Sh200,000 remained unchanged.

“The charges for patients admitted to the Intensive Care Unit (ICU) remain as low as Sh200,000 per day, as compared to Sh500,000 charged before,” Dr Makwabe said.

He highlighted that with the implementation of the new health benefits package, healthcare service providers would incur a 30 percent loss when compared to investment and operational costs.

“Therefore, we believe that negotiations are necessary to enable service providers to continue attracting investment and providing better services to the public,” he said.

According to Dr Makwabe, service providers will not accept new NHIF beneficiaries after the 48-hour period expires, except for admitted patients who will continue to receive treatment services. “This exclusion does not apply to dialysis patients, who will receive treatment for two days before being required to receive treatment by cash,” he explained.

The owner of a health facility, who chose to remain anonymous, criticised NHIF for “hastily” implementing the new benefits package without addressing crucial concerns through mutual agreement.

He noted that delayed payments from NHIF affect various aspects of their operations, including staff salaries, medicine procurement, and payments to government institutions such as the Tanzania Revenue Authority (TRA) and the National Social Security Fund (NSSF).