Story: George Ernest Asare, Kumasi
The Bantama Sub-metro Mutual Health Insurance Scheme in Kumasi (MHIS) generated a total of GH¢821, 246.08 as premium from its clients between 2005 and 2007.
In January this year, the scheme collected a total of GH ¢60,605 as premium.
The scheme, however, paid as much as GH¢2,339,555.84 as claims for the health care provided its clients by health care service providers during the same period.
In January this year, as much as GH¢1,411,089.74 had already been paid as service claims.
As many as 198,388 clients have so far been registered by the scheme in the past two years to enable them to receive quality heath care service. Out of that number 134,942 have already received their identity (ID) cards.
The Scheme Manager, Mr Stephen P. Jalulah, told the Daily Graphic that between 2005 and 2006, the scheme registered a total of 102,028 clients and generated GH¢320,091.70 as premium.
Last year, the scheme also collected GH¢440,546.38 from its clients as premium and that the management was devising the requisite strategies that would encourage as many people as possible from the Bantama Sub-metro to join the scheme.
Mr Jalulah expressed concern about the undue delay in releasing subsidies for the payment of claims and said the delay usually brought them on collision course with the health care providers, something that did not augur well for quality health care delivery.
He suggested that the National Health Insurance Council should release the subsidies to the scheme managers ahead of every quarter to enable them to pay their claims on schedule.
According to Mr Jalulah, the Bantama Sub-metro Mutual Health Insurance Scheme paid average monthly claims to the tune of GH¢80,000.00 to the Komfo Anokye Teaching Hospital (KATH) alone for the services it provided its clients. He said because the KATH was very close to Bantama and was the only referral hospital in the Ashanti Region and its environs, clients from the northern sector always sought quality health care there, compelling the hospital authorities to send all their bills to the sub-metro for payment before their sister schemes later reimbursed it.
He said the scheme’s operations were mostly affected by the huge claims it paid monthly for its clients and clients from sister schemes in the northern sector who sought medical care from the KATH, and the undue delay in getting reimbursed.
He appealed for prompt reimbursement to enable the schemes to respond to the needs of their service providers as quickly as possible.
Mr Jalulah also expressed concern about the multiple hospital attendance by clients instead of focusing on a particular healthcare facility in the metropolis.
He said the multiple hospital attendance did not only undermine its operations due to the number of cards used for the and the increased cost of treatment for the clients, but also affected the treatment of the clients due to the multiple drugs provided for the treatment of the same disease.
He appealed to the clients to stick to a particular healthcare provider to enable the medical officers to appreciate the history of their illness and offer the right prescription and treatment that would enhance their speedy recovery.
He said information reaching his outfit also indicated that some medical officers were abusing the system by using the ID cards of some clients to prescribe drugs for close friends and relatives.
He said they were adopting a mechanism to track down such unpatriotic citizens, arrest and prosecute them and advised such people to put an end to their negative practices before they were arrested and prosecuted.
Mr Jalulah said the Bantama Sub-metro scheme had employed 15 permanent workers, who attended to their numerous clients and said the number was woefully inadequate.
He suggested that the strength of permanent staff be increased to 30 to enable the scheme to attend to its clients in a more effective and efficient way.
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