Universal healthcare will be sustainable, goverment says

Dar es Salaam. The government through the Ministry of Health has assured the general public of the yet to be established mandatory Universal Healthcare Insurance (UHI) saying considerable efforts have been made for its sustainability.

Speaking here, Ms Janeth Kibambe, an economist with the Ministry of Health, told the press that it has taken about six years to learn from the existing National Health Insurance Fund (NHIF) and overseas.

“The government has brought this, to answer the call to provide equitable and decent healthcare for all, in fact; the process started in 2016, we’ve not only learned from challenges by the NHIF, but also from other countries that have established sustainable UHI,” she observed.

Adding that: “Apart from claims by service providers derived from cases related to non-communicable diseases, other challenges that NHIF was facing include the effect of old-age pensions on health care utilisation as the Fund spends over Sh60 billion annually for them, yet it had very limited subscribers.”

According to her, only 15 percent of the country’s population have subscribed to health insurance of which 9 percent are covered by NHIF.

“So you can see, the pool was very limited but with the UHI, NHIF will have more principal members and it will be regulated by Tanzania Insurance Regulatory Authority (Tira), so things won’t be the same.” she noted.

The health economist further expounded that, the current health insurance system did not provide equitable healthcare bundles as each company had its own but with the proposed UHI, the primary bundle will be uniformed regardless of one’s financial abilities, thus insurance companies are challenged to compete.

“The UHI will also strengthen the country’s referral system as currently, one can decide which hospital he/she should access health service, many prefer Muhimbili, but with UHI, one will need to follow proper procedure until he/she reaches Muhimbili hospital,” she said.

For his part, Ministry of Health policy and planning director Edward Mbaga said the proposed UHI Act seeks the 85 percent of the country’s population that dig into their pockets to pay for healthcare services.

He said the UHI would be mandatory, saying however that no one will be arrested because of lacking health insurance as the government will create a system for which everyone will see the need to subscribe with health insurance of his/her choice.

According to him, it was the responsibility of any government to make sure its people are healthy, saying the UHI was meant to serve that purpose.

Moreover, he said the proposed Act also provided exemptions for the elderly, a strategies adopted to promote Universal Health Coverage (UHC) which will use the Tasaf system of identification to ensure inclusivity in accessing health services.

“Tanzania recognises the fact that ensuring access to healthcare services for old people is one of the fundamental factors for ensuring their survival within the midst progression of diseases resulting from old age,” he said.

On the other hand, the government has guaranteed that, despite its plan to establish the UHC, it will not obstruct health services delivered through the improved Community Health Fund (iCHF).

iCHF is currently on a voluntary basis at a district level aimed at increasing access to quality healthcare for people in the rural areas.

According to the President’s Office Regional Administration and Local Government (PORALG) permanent secretary Grace Maghembe, the government will not abandon iCHF, instead it will continue improving the scheme.

“People should not be worried, as they might think the establishment of the UHC will only be accessed by wealthy people,” she said.

Dr Maghembe made the remarks at the 9th Tanzania Health Summit themed “Quality of Healthcare in Tanzania: The Current Status and Area of Improvement Toward Achieving HSSP [Health Promotion and System Strengthening Project].”

She assureed the public and health partners that UHC will not disregard iCHF, instead, people will have access to health services depending on their financial position because some affordable healthcare bundles will be provided.

Commenting, HPSS project manager Ally Kebby commended government’s efforts on health saying: “The proposed UHC is a good thing to the people, and our organisation will work together with the government in ensuring access to quality healthcare.”

He urged the government to provide a conducive environment in terms of health infrastructures that would allow the public to access healthcare countrywide without inconveniences.