Major changes in Universal Health Insurance Bill

Dar es Salaam. The government is making several modifications to its Universal Health Insurance (UHI) Bill in an effort to align it with the needs and aspirations of various segments of the population before it is presented for a second reading in the Parliament next month.

The UHI Bill was presented for the first reading in the House in November, 2022 and was being expected to go through all the three stages of reading during that same sitting [November, 2022 sitting] but it had to be postponed to give a room for further consultations between the government and the Parliamentary Committee on Social Services and Community Development.

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Since then, there have been a number of consultations with various stakeholders which have resulted in the proposed changes.

Presenting the recommendations to editors in Dar es Salaam yesterday, the chairman of the taskforce that was formed to collect stakeholders’ views on the draft law, Mr Bernard Konga said the proposed changes will bring about positive results.

The ministry of Health and Social Welfare organised the event.

“Among the recommendations include that of having a standard benefit package of which each insurance scheme will have to provide and it will include fees like registration, admission, tests, medication, surgery, dental services, eyes treatment, medical/orthopedic appliances and physiotherapy services will be covered here,” said Mr Konga. The information technology systems, he said, will be strengthened to make it easy to manage all the operations countrywide and create a conducive environment for the members to get the needed service.

The health insurance for all will cover up to six family members per home, and the Tanzania Insurance Regulatory Authority (Tira) will be in charge of regulating the insurance and determining citizens who cannot afford to pay for the insurance, with the government accommodating them. In addition to the recommendations, the Community Health Fund (CHF) is proposed to be disbanded due to its weaknesses in providing substandard services that do not match the amount of the payment, people’ unwillingness to join the fund, and so on.

According the presentation, it was advised that the availability of health insurance for all should be linked with other social services as a way of getting more members on board and help the government from minimising costs to treat many people through collections of money. In the proposed changes, the number of requirements for one to access the UHI has gone down to only five from the previous nine.

“We now remain with a driving licence, a motor vehicle insurance, a business licence, a visa for foreigners and admission letters for university students. The four that had been scrapped include taxpayer’s identification, simcard registration, travel document for A-level students and a national identity card,” he said.

Speaking at the meeting Health minister Ummy Mwalimu said the changes of the registration conditions are aimed at getting more people to register with the service.

She said if the bill sails through the Parliament and is signed into law, it will bring about equality in the way retired persons – from both the public and private sectors – are treated when they seek medical services. Currently, while retired public servants continue to enjoy health services under the available health insurance arrangement, their private sector counterparts do not get any consideration and therefore, they must seek alternative ways to access a health insurance scheme. “In case we are able to get this law in place the scenario will change and every retired person will be considered for the treatment regardless of which sector one is coming from,” said Ms Mwalimu.

The law will be rolled out in phases whereby the first one runs from 2023 to 2026.

The second phase, which runs between 2026 and 2028, will also involve the informal sector through business and driving licences while the third one [phase] will be in 2029 and beyond.

With the increase in the number of health centres from 8,449 in 2019 to 10,067 in 2022, the Health ministry believes it was about time the UHC became a reality.

Besides, Ms Mwalimu said, with Sh20 billion being disbursed to purchase medicines each month, all key medicines were available across all the health centres by at least 67 percent as of December, 2022.

The government has also installed modern medical equipment such as X-rays, CT- Scans and Magnetic resonance imaging (MRI). It has also constructed Emergency Medical Departments (EMDs) and Intensive Care Units which have helped in the delivery of quality services depending on the need.

The improvement goes along with the increase of manpower whereby in the 2020/21 financial year, the ministry employed 3,347 whereas in 2021/22, some 9,262 workers were employed. During the current [2022/23] financial year, a total of Sh8 billion has been set aside to support trainings on specialized fields and the improvement of customer care programmes.