Covid charges: Private health facilities wait for govt action

Owners of private health facilities have expressed concern on how government will regulate the prices they charge on Covid-19 patients following a court ruling last week.

The High Court in Kampala ruled that the Health minister, Dr Jane Ruth Aceng, and the Attorney General must make regulations for reasonable fees payable to hospitals for management and treatment of Covid-19 patients.

The court also ordered the Uganda Medical and Dental Practitioners Council (UMDPC) to make recommendations to the Minister of Health regarding the fees.

Mr Moses Mulumba, the head of the Centre for Health, Human Rights and Development, a health advocacy organisation, had petitioned the court in Kampala on June 28, seeking intervention.

Ms Grace Kiwanuka, the executive director Uganda Healthcare Federation, yesterday told Daily Monitor that they are waiting for the ministry to guide them on how it will be implemented.

Ms Kiwanuka said private health facilities are currently struggling with high costs of operation, and wondered how all will be factored in to come up with “reasonable charges.”

“We have been having open discussions with the MOH and UMDPC, we are waiting for them to guide us on the way forward. We will likely need to be informed on the mechanisms and methodology of determining this because every facility is different in its set up and its business obligations from rental of infrastructure and equipment, to where we are able to access inputs, we buy from different suppliers the consumables whose prices fluctuate with market forces,” she said.

Ms Kiwanuka said they have not come up with a definite position, but will wait on what the ministry says before agreeing.
“At this time, it is premature to say this is what we will do, except we will keep serving clients and doing our best as part of the national response in this pandemic,” she said.

Both Dr Aceng and Dr Katumba Ssentongo, the registrar of UMDPC, were not available to explain how they will proceed to implement the ruling.
Mr Kiryowa Kiwanuka, the Attorney General, last week said his office would advise the ministry to comply with the ruling.
It has also emerged that government is incurring huge costs in treating Covid-19 patients in  intensive care units (ICU) and high dependency units (HDU). 

“Treating Covid-19 is expensive and our costs are not almost different from what private facilities are charging. Government incurs up to Shs3m a day for an ICU patient and Shs780,000 for HDU. I don’t speak for the ministry, but you can ask the minister because last week she was in Parliament and gave out the figures to them,” a source said.

Dr Aceng did not respond to our repeated calls on the matter.

Ms Kiwanuka also confirmed similar figures and said private facilities are being bashed yet government spends huge costs, adding that the Shs3m is even low.

“That’s even low since it’s not factoring overheads, indirect costs, statutory costs, license and registration costs, NSSF, and for them they buy in bulk through NMS, we buy from wholesalers and at times retail,” she said.

“Fact is... government says they want Uganda to become a medical tourism destination like Kenya, India, even Tunisia and Ethiopia are trying. How when we are coming up with ideas like fixing prices in a sector that’s already struggling. There are many other ways to regulate prices,” she said

She said government should have come up with subsidies for the private health facilities so that they procure supplies cheaply and the costs for treatment would also come down.

“The challenge in Uganda is many of our policy makers are not exposed to new ways of doing things. You can incentives...you can subsidise to force down the price...you increase competition to force down price...you offer a competitive alternative,” Kiwanuka said.

Private health facilities speak out on charges 

Ms Grace Kiwanuka, the executive director Uganda Healthcare Federation,  said while Ugandans have criticised them for charging high costs, they have never inquired why. “They are the very people when you ask them where they go and why, they say private because they have the equipment and drugs.

Let us accept we are not perfect, but let’s first accept, private facilities are not profiteering and we have ethics and morals and we are not exploiting Ugandans,” she said.  Ms Kiwanuka said the stigma is affecting health workers in private health facilities. She said the facilities are not making any profit because of high costs of operations and tax obligations .

“It is affecting mental health of the private health facilities. Like we told Parliament, health facilities in Uganda are so not profitable  and most have been bought out by equity investors. The indigenous ones have all had to get equity investors because it’s a very tough business to sustain,” Ms Kiwanuka said.

She wondered how Uganda can compete with other countries in offering the best treatment when government fixes prices.