THE government has assured the public that it will do everything in its capacity to keep the National Health Insurance Fund (NHIF) afloat.
Speaking to reporters here yesterday, Minister for Health, Ummy Mwalimu said the government was devising urgent measures to ensure sustainability of the NHIF, noting that increased claims stretched the funds’ financial muscle.
“The fund’s operating costs are increasing as a result of spiraling claims, but income generated from health insurance bundles is not enough,” she added.
However, Minister Ummy assured the public of sustainability and viability of provision of health services through NHIF.
Among measures sought by the government include preventing the increasing rate of costly non-communicable diseases, which are among the key reasons that threaten the well-being of NHIF.
She also insisted that the government will strengthen accountability to ensure NHIF stays on the course.
The ministry, she said, has come up with a number of interventions to rescue the situation such as fast-tracking the use of mandatory universal health insurance for all. She said the insurance for all schemes will commence soon.
She also said that the government will continue to step up measures in creating awareness to members of the public on change of lifestyle, which are the main sources of NCDs that consume exorbitant funding in treatment.
“For sustainability and viability of the NHIF, soon we are going to announce the health insurance for all cover for every citizen which will be accessed at a reasonable and affordable contribution amount to widen the scope of members, regardless of age,” she said.
Under the health insurance scheme, she said, every citizen will be eligible and it will be tied up for accessing other services like national identity cards, passports and other facilities.
Ms Mwalimu said NHIF with 4.8 million beneficiaries as of June 2022, was overwhelmed by claims, saying 99 per cent of voluntary members join the fund when they are sick mostly of NCDs.
“If nothing is done, the health insurance fund may collapse as it is overwhelmed by a sharp rise in claims related to non-communicable diseases,” she said.
NCDs represent a group of chronic conditions, including cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes.
Ms Ummy said Tanzania needs to embark on a public awareness campaign meant to detect early signs and symptoms of diseases, and how to prevent them.
Giving figures, the minister said NHIF was paying 9bn/- in 2015/16 a year for cancer patients compared to 22.5bn/- in 2021/22, dialysis shot up to 35.4bn/- in 2021/22 from 9.5bn/- in 2015/2016, CT-Scan and MRI costs stood at 10.89bn/- in 2021/22 compared to 5.43bn/- in 2015/2016.
Ms Mwalimu tasked the NHIF management to put their house in order in curbing massive fraud committed by some healthcare providers.
The minister said that urgent action was needed to rescue the fund including a massive campaign to recruit more members since claims lodged by service providers far outstripped NHIF’s income.
Ms Mwalimu directed the ministry’s permanent secretary to ensure in two -weeks’ time, they put in place an effective ICT system that would help it control spending and curb fraud.
NHIF has been accusing owners of some health facilities of submitting fraudulent payment claims warning that this was sabotaging the government’s efforts to expand health insurance coverage.
Recently, insurance and social security experts called on the government to bail out the fund as a short-term measure. They also suggested that the government should also design social bonds to raise funds through the capital market.
Instead of leaving NHIF purely under the Ministry of Health, the government should also consider putting it under the regulatory role of the Tanzania Insurance Regulatory Authority (Tira).
Its benefits and price level should also be restructured while health insurance must be made compulsory for all Tanzanians.
“There is a need for NHIF to be regulated. At the same time, hospitals that accept NHIF cards must be connected to the Tira system so that they can be regulated through digital innovations,” suggested the Insurance Commissioner at Tira, Dr Baghayo Saqware.