How Tanzania's health insurance will be funded

Dar es Salaam. The government yesterday unveiled its potential sources of money to finance health insurance for poor Tanzanians after submitting a revised bill which seeks to ensure the protection of all.

The Universal Health Insurance Bill was tabled in Parliament for the first time in September 2022 but was recalled before deliberations after the House committee analysed it and public concerns over some sections in the proposed law.

One of the major contentious issues was lack of clear financing mechanisms for people who cannot afford.

Health minister Ummy Mwalimu yesterday tabled the reviewed Bill which identified the sources of revenue to cover the contributions of the poor Tanzanians.

According to her, the government will establish an equity fund which will be used to pay the insurance premium for poor Tanzanians and finance the cost of treating chronic diseases such as cancer, kidney and heart problems, and emergency services like accident treatment.

“We have been receiving a lot of complaints about people failing to meet the cost of treating these chronic diseases. The government will take care of the cost of treating these diseases,” she said.

Speaking about the sources of revenue for the fund, she said the money will come from levies on carbonated drinks, liquor, cosmetic products, gaming tax, motor vehicle insurance fee, and electronic transaction levy.

“These sources are not new but the Minister for Finance has agreed to set part of the money to finance the insurance of poor Tanzanians,” Ms Mwalimu said.

She said other sources include the budget to be allocated by the Parliament, revenue from the insurance fund’s investment and support from other development partners.

“We are going to revoke the exemption system which has not benefited people. The system is on papers but in most cases, exempted people do not get medicines and other services,” she said.

Section 22 of the Bill requires the ministers for Health and Finance to consult and identify specific sources of the money for financing the poor Tanzanians who cannot afford.

The financing mechanism is expected to benefit some 15.8 million Tanzanians who are estimated to be poor.

By September 2023, 15.3 percent of Tanzanian population were estimated to be using health insurance services, making it difficult for majority to access quality health services due to limitations on financial resources.

More changes

The government made other changes in the Bill as proposed by the parliamentarians and other members of the public.

Ms Mwalimu said the government repealed a section which restricted some public services for people who had not subscribed to the government’s health insurance schemes.

Previously, the Bill restricted access to services such as driving licence, motor vehicle insurance, tax identification number (TIN), Sim card registration, business licence, passport or visa, registration of students, and national ID.

Ms Mwalimu said the section was scrapped in response to public demand but the government introduced “sanction” to make it necessary for people to join the insurance coverage.

“We will invest in public awareness programmes and convincing people to join,” she said.

“There will be a penalty of 10 percent of the annual contribution for a person who do not join any of the insurance scheme after three years since the law started,” she added.

Ms Mwalimu also said the demand for an every employer to pay at least six percent of employee salary as contribution to the government’s insurance scheme was now relaxed to allow private sector employers to choose the preferred insurers.

Committee reacts

Parliament’s Health and HIV/Aids Committee applauded the government for tabling the insurance Bill which it said will revolutionise the provision of health services in Tanzania.

“This is a basic step towards ensuring Tanzanians live in good health by accessing the health services timely,” said committee chairperson Stanslaus Nyongo.

The committee, however, advised the government to now identify operational mechanisms to sustain the established fund.

The committee also advised the government to introduce a three-month grace period to renew the policy to give enough time for people who lost partners to pay.

Mr Nyongo said the government also needs to conduct actuarial study to determine the current contribution rate and the exact amount needed for the equity fund to finance the poor.

He also urged the government to ensure provision of proper health services in its facilities after introducing the insurance coverage.

After deliberations in which most MPs supported the draft, the House approved the Bill yesterday.