The Insurance Regulatory Authority (IRA) has clarified that not every individual will be subject to a fixed monthly charge of 15,000 Shillings for the proposed National Health Insurance Scheme.
Health Minister Dr Jane Ruth Aceng had initially suggested that all Ugandans, along with their dependents, would be required to pay this amount, but Ivan Kilameri, an Actuarial Manager at the Authority, clarified that employees in the formal sector will contribute a percentage of their salary based on established bands. This contribution will be deducted by employers at the source.
Speaking at a meeting discussing the feasibility of the new scheme, Kilameri explained that only formal workers earning 235,000 Shillings or less would be expected to contribute 15,000 Shillings per month.
He also noted that refugees would be subject to the same contribution under the new proposals.
According to IRA, contributors will have benefit limits of up to one million shillings for outpatient care and five million for inpatient services.
The costing of the scheme has been guided by claims experiences from thriving community health insurance schemes in different parts of the country and benchmarking from countries with successful public schemes.
Kilameri emphasized that while community schemes are voluntary, everyone would be required to contribute to the new scheme, with IRA providing oversight.
However, some sections of the Ugandan population are expressing reservations, fearing potential misuse of the funds. Dr Robert Kalyesubula, a senior lecturer at Makerere University and doctor at Mulago Hospital, believes that while a public insurance scheme would be beneficial, individuals should not be coerced to pay.
He emphasizes the importance of choice and giving people reasons to contribute willingly, especially considering past government accountability issues.
Timothy Chemonges, a Policy Analyst, suggests that policymakers should ensure the fee is inclusive and that the public understands the reasons behind the contribution before introducing the scheme.
He raises concerns about potential resistance, especially given unresolved corruption issues in the country, citing recent concerns with the National Social Security Fund (NSSF).
Dorothy Amuron, a lawyer at the NGO Center for Health, Human Rights and Development (CEHURD), recommends that the Ministry of Health develops strategies to build public trust.
She emphasizes the need for a feasibility study to assess public trust and more benchmarking to avoid the scheme facing challenges after years of effort.
The push for a National Health Insurance Scheme in Uganda has persisted for over two decades, with the latest attempt in 2021 seeing the bill withdrawn after passing in parliament. The government cited gaps that needed addressing following thorough consultations with stakeholders.