Optimism as Universal Health Insurance approaches

The president's ratification paved the way for the Health ministry to formulate regulations for the commencement and implementation of the law later this year.

The development came after challenges related to how the poor would be funded during the implementation of the UHC, therefore stalling the process since 2018 had been provided with pre-requisite answers.

In order to cater for the health needs of over 15.8 million poor Tanzanians (around 26 percent of the population), the law reveals the funding sources, including service levies on carbonated drinks, liquor, cosmetics, gaming tax, motor vehicle insurance, and electronic transaction levies.

The poor are the ones to celebrate following the miseries they faced when accessing treatment services in different healthcare facilities, including those owned by the public.

Some victims of the said grievances shared the situation during a recent interview with The Citizen.

A resident of Mwanza, Ms Halima Hussein*, said back in 2017, her sister was admitted to a public hospital after slipping and accidentally falling in the bathroom.

She says family members were informed the following day that treatment for ailing relatives had been suspended until the Sh200,000 bill would be cleared.

“The amount was part of charges accumulated for services received since her arrival, including x-rays,” she says.

She recounts that it was a burden to the family that had lost a mother two weeks ago after a long illness, therefore severely affecting its economy.

The patient was abandoned without treatment for four days when a family friend provided the money to pay the bill.

"Unfortunately, it was too late. The same night, the patient's condition deteriorated and worsened. She died on the following day,” she narrated amidst tears.

Ms Hussein believes that her sister’s life would have been saved if the hospital had continued to provide services, but they were robbed by a relative because of the family’s poverty.

A resident of Dar es Salaam, Mr John Dominick, says his young son was admitted to the Intensive Care Unit (ICU) after contracting brain infections.

He says the Dar es Salaam hospital was charging an average of Sh200,000 to Sh250,000 per day, which the family managed to pay for the first 21 days.

"Failure to pay the money had repercussions on the quality of services provided to the patient. The hospital management said the quality of treatment will be reinstated after the treatment bill has been cleared,” he laments.

Furthermore, he says healthcare service providers turned out to be bitter even to visitors who were not relatives.

By the time the patient died, Mr Dominick says the outstanding amount stood at Sh21 million, therefore being restricted to collecting the corpse for burial.

"It was an internal pain for family members because the amount couldn’t be afforded by the family. However, we were cautioned that further delays will force the government to oversee the burial,” he says, inflicting more pain in our bleeding hearts.

“Not only was the family robbed of the right to bid farewell to their beloved one, but they also conducted his burial according to family tradition, custom, and procedures,” he adds.

According to him, the family managed to get some money from a good Samaritan, and after the payment had been made, the body remains were handed over for burial.

That was after being given a debt repayment timeframe and having his national ID withheld as part of the security.

Contacted The Medical Association of Tanzania (MAT) President, Dr Mugisha Nkoronko,said the majority of Tanzanians cannot afford medical charges in the present setting.

“They are unable to pay as well as incapable of meeting exemption criteria, therefore placing them in a debt trap. This will only be avoided once citizens enrol in health insurance,” he said.

He said endorsed execution of the UHC and making it mandatory for all citizens would provide a lasting solution to the vulnerable Tanzanians.

The Muhimbili National Hospital (MNH) head of public communication unit, Mr Aminiel Aligaesha, said hospitals were grappling with the shocking increase in treatment and operation costs.

"Hospitals spend a lot of money on operation costs; therefore, debtors have a responsibility to service their debts for the sustainability of services," he says.

However, he said procedures have been put in place for poor Tanzanians to be exempted from treatment bills.

“A total of Sh15 billion has been forgiven in the 2022/23 financial year, with another Sh3.4 billion charged and exempted so far for the 2023/24 financial year,” he said, mobilising Tanzanians to enrol in health insurance.

Tabling the bill in Parliament in November last year, Health Minister Ummy Mwalimu said the government had suggested the establishment of a special fund that would settle the cost of health insurance for vulnerable groups in the country.