Fredrick Makaire, the Executive Director Save for Health Uganda an umbrella organization for informal community health insurance schemes said the Ministry of Health came out to resist the bill rather late and failed to carry out its mandate of sensitization.
Experts have said that the public and the politicians that passed
the National Health Insurance Scheme (NHIS) bill which is touted as one that
will enable Uganda to achieve health equity are completely ignorant about it.
Fredrick Makaire, the Executive Director Save for Health Uganda an umbrella
organization for informal community health insurance schemes said the Ministry
of Health came out to resist the bill rather late and failed to carry out its
mandate of sensitization.
As a result, he says a lot of people are seeing the NHIS as
another tax that will add on their already existing burden of taxes, others
think that they will be refunded if they don’t use their annual contributions
and yet the ministry has been receiving 3 Billion Shillings annually for
preparation of this bill of which part of the money was supposed to go towards
//Cue in: “That Ministry has…
Cue out: “…it is a tax”. //
Instead of doing sensitization locally, Makaire says officials
resorted to utilizing the money in foreign travels.
//Cue in: “But then the…
Cue out: “…there’s that misunderstanding”. //
It’s still unclear whether this bill that was forwarded to the President
for accenting will be signed into law since health minister Dr Jane Ruth Aceng
has severally warned that it may not see the light of day.
She said, on March 31st when it was passed, her junior Minister
Robina Nabbanja tried to stop parliament so that they could address the missing
links but failed. For her, as it is now the bill doesn’t address concerns
raised by the stakeholders who are expected to contribute to the scheme.
The Health Insurance bill seeks to provide health care for all
Ugandans at an affordable cost with funding from Ugandans both in the formal
and informal sectors.
Those employed in the formal sector are supposed to contribute 4 per cent of
their salaries backed by a one per cent contribution from their employers.
Individuals in the informal sector are supposed to contribute 100,000 Shillings
annually. The bill exempts the poor from contributing.
But Aceng says in proposed changes that were missed out is for all Ugandans,
regardless of their employment status, to pay a certain amount of money to
access health care.
Currently, she says the piece of law is not only unpopular to investors
but workers too because it is viewed as a burden for people who still earn less
such as health workers.
//Cue in: “The bill in its…
Cue out: “…We had dialogue”. //
Dr Francis Runumi, the former commissioner of Health Services in charge of
planning who was at the forefront of this bill before retiring in 2015 says the
same concerns were raised when the bill was first proposed more than ten years
He says employers run to President Museveni that they would not afford that
extra burden of contributing to the scheme but when they explored with the
communities in Kisizi in Western Uganda, within a short period people bought
into the idea and that is how informal community insurance schemes came into
He says establishing a scheme needs creating more knowledge about
it than just the money to invest.
/Cue in:” Many people around…
Cue out: “…left us out”. //
Already he said as early as 2001, the school of public health had
come with enough knowledge base that could be used to establish an effective
scheme with even contributions from the informal sector.
//Cue in: “Within a very short…
Cue out: “…Can come in”. //
Even as free care is being touted as an alternative, currently he says there
are no free health services in Uganda even as politicians say there’s free
health care. He says good quality health services are costly and can’t be borne
by just an individual.
//Cue in: “Many people know...
Cue out: “…come to a check”. //
For him, Uganda will not achieve health equity without having the scheme in