Achieving universal health coverage in Ghana: A matter of feasibility or Political Will?

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Good health is indispensable to human welfare and to sustained economic and social development. The best way to finance health care has long been a confusing area for policy-makers resulting in different policy options being debated for decades. Recently, government announced its decision to implement a one-time premium health insurance policy as a means of making health services accessible to all and citizenry in the country. This article aims to contribute to the health-financing debate and particularly argues that free healthcare policy is feasible in Ghana but will only require a political will to achieve this noble dream.

Is NHIS really covering the poor?
The NHIS undoubtedly provides a comprehensive package of services and for members of the scheme evidence suggests that access and quality of services have improved. Nevertheless, some research reports by civil society organisations (e.g. ISODEC, the Alliance for Reproductive Health Rights and the Essential Services Platform with support from Oxfam) recently noted that the yearly subscription of the scheme has been a barrier towards poor people‘s access to healthcare services in Ghana. For many people, the health insurance system is acting as a costly and inefficient barrier to claiming the health care they have already paid for (through VAT). The NHIS as currently constructed cannot therefore achieve Universal Coverage for health care in Ghana. The only way forward is to move towards the stage where healthcare really becomes free for people at the point of use or to strike away annual subscription fees and allow people to enjoy the service for their entire lives once they join—what the Government termed one-time premium.

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