Do you have health insurance?
“Oh no, that thing covers only paracetamol. I won't waste time on it. I will rather pay for all services when I visit the hospital.”
The above exchange is a familiar response you often get from many people when asked about their NHIS membership and status. Well, that's not entirely true.
The National Health Insurance Scheme has limited cover. However, it certainly plays an important role that has little or nothing to do with personal affordability.
Even if you are financially capable of paying for all your healthcare expenses, not having active National Health Insurance Scheme (NHIS) coverage can cost you dearly in Ghana's healthcare system. I say this from practical experience as a healthcare provider.
Let me explain
NHIS covers some of the most basic and yet lifesaving medical supplies and procedures in our healthcare facilities. Some of these include; regular Intravenous fluid (drips), medications, lab investigations etc.
Once a patient's NHIS is active, health facilities have a system in place to ensure he or she gets access to all these basic healthcare needs without delay and with zero effort from relatives.
This is what happens when a patient visits a hospital without NHIS coverage but has the money to pay for all expenses: the patient and their relatives must play an active role in accessing all crucial basic medical items and procedures.
When a client has active NHIS coverage, it is the full duty of healthcare providers to ensure that all services covered under the scheme are rendered. For instance, it is the responsibility of health staff to ensure that all prescribed medications are made available at all times and that all procedures, such as laboratory investigations, are carried out without excuses.
To make this easier, for example, there are in-service pharmacies located within the wards and units for quick access. If a person comes to the hospital without NHIS coverage, part of this responsibility shifts from health staff to the patient and their relatives.
This implies that a patient may have all the money and still be deprived of important medical interventions. This is because most hospitals in Ghana do not readily provide medical supplies to non-NHIS clients unless they are purchased. The in-patient pharmacy within the unit does not sell supplies even if you have money. They provide only free services under NHIS.
In this case, the health staff now is left with the option of going outside, far away to purchase treatment items for the non-NHIS patient and honestly speaking, they don't always do that. You cannot entirely blame them. If no relative is around to run such errands all the time, patient may have a bag full of money in his locker and still lack basic vital treatment.
This explains why no matter how financially stable you are, make it a point to have an active NHIS coverage.
Non-active NHIS Clients (rich or poor) Frustrate Healthcare Providers
Let me tell you for a fact: healthcare providers sometimes get frustrated when a patient comes to the hospital with no active NHIS and without very supportive relatives. Such patients often make their work more difficult because it puts them in a position not to have easy access to basic medical items to complete their tasks.
Again, such non-NHIS patients may ‘help’ lazy healthcare providers who may never be interested in going extra mile in discharge of duty. For instance, a nurse may not serve prescribed vital medications because no relative is around to go and purchase from a far distance pharmacy shop.
Certain key lab investigations may not be carried out on time because they are waiting for relatives to go and make payment before patient is sent. It's even more frustrating if patient's condition is very bad and he or she could barely interact with staff.
In the final analysis, NHIS may not cover much of certain healthcare services. You may be rich enough to pay all expenses but considering the explanation in this write up, it is advisable to get yourself and loved ones enrolled in the National Health Insurance Scheme. It may be of great service to you one day.
The writer is Bernard Agbonoshie; a registered nurse, author, public speaker and the owner of Bernajis Media Group.
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Powerful! Thanks for sharing.
Thank you. Very informative and educative.