Healthcare insurance in Uganda: People to pay out of pocket for some health services

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Healthcare insurance in Uganda: Those seeking healthcare under the National Health Insurance Scheme (NHIS) that is being discussed in parliament will have to pay for any extra services that they seek outside what is prescribed in the scheme.

Ronald Baggaga, the Legal Counsel to the parliamentary health committee, says discussions of the bill that establishes the scheme that is being touted as a solution to Uganda’s healthcare system that is riddled with high out of pocket expenditure and bribery are complete. He says the bill is only awaiting presentation to parliament for the third reading.

Bagaga explains that the bill includes a schedule stipulating what health services contributors can access and the cost beyond, which the patient will have to pay out of the pocket.

Responding to concerns how the informal sector will be included on the scheme together with community health insurance schemes that sections of Ugandans are currently informally accessing, Baggaga said the bill is silent on the incorporation of the private and community health scheme, which means people can enrol on both.

The bill provides for mandatory contributions for those formally employed and self-employed under Clause 24. It provides that contributions to the scheme by those that are in self-employment will be determined after assessment by the board.
Aliyi Walimbwa, a senior health planner in the Ministry of Health who is also the desk officer for the scheme, said those in self-employment will contribute money from their income as government plans to assess their earnings on an annual basis.

He said they are coming up with guidelines for people to pay and that they have instituted penalties for those that don’t comply. While committee indicates that they are ready to present the bill for the third reading, the committee chairperson Dr. Micheal Bukenya told a meeting organized by Partners in Population and Development-PPD that there will be delays caused by the disruptions of the electoral season.

Bukenya said while he anticipates to have the bill in place by the end of the parliamentary session, he said their final meetings with key people including the Minister of Finance have been halted because of the NRM primaries.

On his part, Achilles Kiwanuka, a Programs Officer with PPD, said the timing of the bill in the lead to the general elections is politically sensitive and presents a double edged sword, saying whereas the bill is important in addressing healthcare financing, it’s considered a tax by some.
He says government might want to stay it until after elections even as it has dragged on for the last eighteen years and was only reintroduced by government in August last year because of pressure from NGOs and health advocates for it to be discussed and passed.

For now, Walimbwa revealed that government is conducting a study to identify the indigents in the country who need health insurance in Uganda. For him, the scheme will not just benefit citizens of Uganda but all recognized residents in the country.

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