Fast track the national health insurance scheme

Innocent Joseph Kyeyune

The media has been filled with stories of hospitals detaining bodies of deceased Covid-19 patients due to failure to pay treatment bills. It is noteworthy that it is unlawful for a hospital to detain a corpse so as to recover a debt because a corpse isn’t property subject to attachment. Moreover, such practice is repugnant to public policy because the dead are entitled to a dignified rest, at least as much as we can accord. 

The most appropriate remedy  to the hospital in such circumstances  is  to negotiate flexible payment schedules with the deceased’s family or  if the family is uncooperative, institute a civil suit for recovery of the debt.

The Covid-19 pandemic has merely exposed a stinking wound but these things have often happened. Men have had their wives “confiscated” after labour and dead bodies detained in morgues longer due to unpaid hospital bills. The lucky citizenry are able to access treatment and later struggle with the  exorbitant bills but majority cannot even afford to pay the initial instalments required by most hospitals before a patient can be attended to. 

Oftentimes, people have had to organise car washes and all manner of fundraising means to raise medical treatment fees for loved ones in need of specialised medical treatment. Worse still, the biggest portion of our population cannot even afford organising the fundraiser itself! 

But for how long and for how many patients will fundraising be made? It is high time every person had a health insurance cover so that one doesn’t always to have cash with them in order to access healthcare, which is a basic right. 

Through health insurance, the rich subsidise the poor and the healthy subsidise the sick thereby ensuring that everyone has access to healthcare whenever they need it. It follows that a comprehensive and transparent national health insurance scheme accessible to all people would substantially solve the bulk of problems affecting our limping healthcare system since every person will be able to afford medical treatment whenever they need it. 

In March this year, after nearly a decade of shelving the Bill, the Parliament enacted the National Health Insurance Scheme Act and it now awaits assent by the President. The Act provides for the establishment of the National Health Insurance Scheme to which every person who has attained the age of 18 years and ordinarily resides  in Uganda must contribute and mandates the government to make contributions for the indigent. Salary earners will contribute to the Scheme through monthly salary deductions and employer contribution whereas self-employed members will make annual contributions.

According to the National Health Insurance Scheme Act, all government hospitals and health centres will be healthcare service providers under the Scheme. Private health facilities will need accreditation in order to provide services under the Scheme. Unlike now where one needs to have money before they can access quality healthcare services, members of the National Health Insurance Scheme would only be required to present their membership cards at the health facility and receive services without necessarily making cash payments. 

The National  Health Insurance  Scheme, if properly implemented, will ensure accessibility and affordability of quality healthcare services to all people irrespective of their socioeconomic status. This won’t only save  households the burden of footing high out-of-pocket costs but also enable the poor access quality healthcare from both public and private health facilities. 

With the costly lessons picked from the Covid-19 pandemic, the Government should fast track the transparent and efficient implementation of the newly enacted National Health Insurance Scheme Act as one of the measures to improve the healthcare system in Uganda. 

Mr Innocent Joseph Kyeyune is a lawyer and human rights activist.