In June 2019, the National Health Insurance Scheme (NHIS) bill was approved by Cabinet and subsequently tabled before Parliament. The bill was referred to the Parliament’s Health Committee for scrutiny.
In its consultative process, the Health Committee Chaired by Hon. Dr. Michael Bukenya received a number of views from various stakeholders. As a critical stakeholder representing the views of the Insurance Sector, the Insurance Regulatory Authority of Uganda advised that an immediate actuarial study should be carried out to determine the contributory rates for employees, employers and those in the informal sector under the NHIS. To date, the discourse on the bill has not yet been concluded.
Little did we all know that in the following year 2020, we were set for a health crisis, the novel COVID-19 pandemic, which has heavily disrupted the global health system. The outbreak has not only manifested as a public health emergency causing large-scale loss of lives and human suffering but it has also disenfranchised the global economy.
Many communities that hitherto relied on the government’s free healthcare programs are experiencing reduced access to primary healthcare. Reports indicate an increase in the number of preventable deaths during childbirth, health emergencies and other occurrences of deaths due to preventable diseases like malaria.
The pandemic has indeed disrupted Uganda’s progress in achieving the Sustainable Development Goals and specifically goal 3 which aims at ensuring healthy lives and promoting the well-being for all and at all ages, ending poverty and reducing inequalities. This pandemic has created a toll on the health sector significantly causing a drastic change in the lives of Ugandans who have to adapt to the new normal and practices in order to stay safe.
The worrying situation this pandemic has caused will undoubtedly affect our Health Financing Strategy 2015/16 – 2024/25, which came at the time of the global commitment towards Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC). The financing strategy is anticipated to serve as a critical element in the pathway to achieving the health-related SDGs and attaining UHC while emphasizing access to good quality health care according to needs, and at the same time limiting exposure to financial risk for those who seek care.
Whereas government has set the right direction in developing the NHIS Bill, it’s time we expedited the process. Many countries have already established such schemes to raise resources for health and ensure access to health care through financial risk protection. In the East African region, one of the reasons why insurance penetration is considerably higher in other partner states compared to Uganda is the root taken to diversify and strengthen health care financing. These States have health insurance schemes where contributions are made to bridge the financing gap in the health sector.
Operationalizing the NHIS will stimulate providers to avail good quality, accessible and affordable healthcare, as well as increase welfare gain in healthcare and ensuring that everyone has financial access to health care.
The major principle in a health insurance scheme is to promote social solidarity and pool resources for the rich to subsidize the poor, the single to subsidize already established families, the healthy communities to subsidize the unhealthy and the young working population to support the old to enable them access health care.
This pandemic should awaken the discourse on how our health systems should build the required resilience to withstand such shocks. We ought to appreciate that healthcare financing through the NHIS shall create opportunities for Uganda to achieve Sustainable Development Goal 3.
Whereas the uptake of insurance is relatively limited, we can confirm that the community and village-based health insurance initiatives have supported a segment of the populace. We, therefore, need to appreciate that the NHIS will address the needs of the underprivileged, under-served, and most vulnerable communities.
In the spirit of protecting the public in the fight against COVID-19, and in the spirit of building a resilient health system for the country and the economy, we should turn our energies towards having the NHIS bill passed into law. This will in turn accelerate the efforts to achieve the SDG 2030 Agenda and Uganda’s Vision 2040. Fortunately, the Insurance Industry under the stewardship of IRA has recognized the importance of sustainable investment strategies and we are aware of the challenges the country is encountering to mobilize the financial needs to address the post-COVID-19 situation.
Since the Insurance Industry has survived the initial shock of COVID-19, it has become ambitious in exploring meaningful and impactful ways of financing emerging risks, keeping in mind that insurance is a risk protection mechanism that needs to be prioritized and adopted as a national policy.
Alhaj Kaddunabbi Ibrahim Lubega
Chief Executive Officer
Insurance Regulatory Authority of Uganda