Budget 2024/25: Private hospitals call for NHIF debt settlement

Dar es Salaam. As Tanzania prepares to unveil its Sh49.35 trillion budget for the 2024/25 financial year, health stakeholders eagerly await Finance minister Mwigulu Nchemba’s plan to address the National Health Insurance Fund (NHIF).

Speaking to The Citizen, the chairman of the Association of Private Health Sector Facilities in Tanzania (APHFTA), Dr Egina Makwabe, said that with all the discussions they have had with the government, they have one major expectation, which is the NHIF debt settlement.

The debt, he said, affects service provision in most of the private healthcare facilities in the country.

“As we speak, for the past five months, NHIF has not been able to pay their debts, and it is a huge amount, which goes up to about Sh300 billion. In reality, NHIF is a bankrupt institution that cannot pay debts on time,” said Dr Egina.

Read: Relief to NHIF as some private hospitals reverse suspension

Adding to that, he said, the government ended up reducing medicine prices as a way of reducing the burden on them while affecting the private hospital owners. They are looking forward to seeing the government pay debts so they can operate as they should.

“We are not in a position to tell NHIF what to do, but we advised them to pay attention to debt collection to help them offset the huge amount of money that can be paid to private health facilities for their survival,” he adds.

Dr Egina said that failure to do so will put the entire pharmaceutical industry in danger of collapse, and even the drug industry will not be able to continue with production.

A health economist and lecturer at the Muhimbili University of Health and Allied Sciences (MUHAS), Dr Alphoncina Kagaigai, said Tanzania has passed the law to introduce a mandatory health insurance scheme with which will now be known as Universal Health Insurance.

Previously, we had four types of health insurance, namely NHIF, the improved community health fund (iCHF), private health insurance (PHI), and the social health insurance benefits scheme offered under the NSSF (SHIBS).

“We need stable and sustainable financing for the law to be implemented smoothly. Multiple sources of financing with a strong commitment from policymakers have to be considered,” said Dr Alphoncina.

She said it is expected of the government to come up with the best ways to finance these schemes and proposed the establishment of the special risk pool, which will pool the resources from different organisations, private individuals, and any other source aiming to finance health.

Other ways to finance these schemes are to establish a special tax for health insurance on income or payroll tax for formal sector employees, a sin tax (taxes on alcohol, beverages, and tobacco), a membership contribution, a VAT tax, and a special fund or mechanism to exempt the poorest.

For his part, the clinical coordinator at TMJ Hospital, Dr Kaduri Ombeni, said the new NHIF package is quite comprehensive as it covers most medical services to be provided, except a few areas that require improvements to medication.

Read: Association of physicians say they expect better NHIF services

Adding to that, he said, there are about 178 new medicines that have been added to the package but have yet to be implemented. The major concern for the private sector is that the prices set by the fund for medical services are not in their favour as stakeholders, but reconciliation is still ongoing.

“So as we are approaching the budget month, we urge the government to inject more money into the fund so that both health providers and beneficiaries can benefit in the sense that the provider will have sustainable capital to cut costs for the provision of medical services intensively, and at the same time, the beneficiaries will have access to medical services without failure or incurring extra costs,” said Dr Ombeni.

Just a few months ago, Tanzania went through a very hot discussion regarding the use of the new health benefits package as announced by the National Health Insurance Fund (NHIF) at the end of February this year.

The government announcement was later followed up by an official statement from the Association of Private Health Sector Facilities in Tanzania (APHFTA), the Christian Social Service Commission (CSSC), and the National Muslim Council of Tanzania (Bakwata), saying the conversation to reach an agreement between them and the Ministry of Health through the formed committee by the ministry did not bear fruit, and they never concluded.

A few days later, the government directed the private health facilities to continue serving NHIF members as they left the doors open for more conversation with private hospital owners.