The Ministry of Finance, Planning and Economic Development has issued a Certificate of Financial Implications for the National Health Insurance Scheme (NHIS) Bill which is projected to start in financial year 2018/2019. The certificate allows the Ministry of Health to present the NHIS Bill to Parliament for discussion.
The certificate dated 7th April 2017 and signed by the Minister of Finance, Planning and Economic Development, Hon. Matia Kasaija, indicates that government and private employees will contribute 4 percent of their monthly salary to the NHIS while employers will contribute 1 percent of each employee’s monthly salary. Self-employed individuals will pay shs100,000 per year while pensioners will contribute 1 percent of their monthly pension payment.
The certificate further indicates that indigents will not contribute to the scheme but will be subsidised by other members of the scheme. It will take 10 years for all indigents to be covered as only 10 percent will be enrolled per year.
Ministry of Health has written to Finance Ministry seeking a certificate of financial implications after it amended some of the controversial clauses to the National Health Insurance Scheme (NHIS).
The certificate of financial implications shows that there are funds for the implementation of the Bill once it has been passed into law and it is a requirement before any Bill is tabled in Parliament for first reading.
The National Health Insurance Bill 2007, was hatched about 13 years ago and up to date has not been tabled in Parliament.
The Bill seeks, among others, to lower the cost and improve the quality, safety, and efficiency of healthcare in Uganda.
However, if passed into law, the Bill will make it mandatory for civil servants and formally employed Ugandans to make contributions to a National Social Health Insurance (SHI) Scheme.
A letter to the Permanent Secretary and Secretary to the Treasury, Mr Keith Muhakanizi seen by Daily Monitor, indicates that an amendment where only 10 per cent of the indigents or poor people will first be enrolled to benefit from the NHIS as opposed to an earlier proposal to register all the seven million people.
The proposed amendments by the Ministry of Finance also introduce 1 percent deductions from the pensioners’ monthly salary and Shs100,000 annual contributions for the self-employed in the informal sector.
Rwanda’s Health Financing Sustainability Policy of 2015 states that the country ‘has achieved close to universal population coverage of health insurance through the innovative design and implementation of a combination of mandatory insurance schemes tailored to fit the needs and financial capacities of different segments of society’.
Currently, the country has four insurance schemes:
The country’s achievements through the above schemes are attributed to a number of factors: