High health bills sicken Ugandans

Healthcare financing in attaining universal health coverage is indisputable. Referring to the article published in the media on August 23, 2024, on how the high health bills are sickening Ugandans, it was stated that the amount of money Ugandans spent on out-of-pocket expenditure on healthcare increased by Shs88.3 billion between 2019/2020 and 2020/2021, from Shs2.21 trillion to Shs2.3 trillion. This was according to the Ministry of Health National Health Accounts report released on August 22, 2024.

The report further notes that over 90 percent of household expenditure went to curative care, whose main component is medical care goods like pharmaceuticals. 

Ugandans are indeed experiencing financial hardship when they are directly paying out-of-pocket bills for health care. Even small out-of-pocket payments to get painkillers such as paracetamol, are a strain for many households across the country who also do not have enough money to meet other basic needs.
 
The situation is even worse when it comes to those who have to pay for long-term treatment such as medicines for chronic illness.
The lack of financial protection reduces access to health care, undermines one’s health status, deepens poverty levels, and worsens health and socioeconomic inequalities in our communities. The cost of needed services and treatments requires people to use up their life savings, sell assets, or borrow, destroying their futures and often those of their children. 
Unfortunately, the savings that many of these households would use to support Uganda’s economic development are instead used to protect the lives of their loved ones.

The solution to the big financial burden on households and individuals is to expedite the implementation of the National Health Insurance Scheme (NHIS), whose major aim shall provide access to quality and affordable healthcare services to Ugandans especially those who cannot afford medical treatment.

Implementing the NHIS will protect Ugandans from unexpected and high medical out-of-pocket costs, allowing them to pay affordable premiums and get treatment based on a basic cover. 

Under the NHIS, it is proposed that every Ugandan shall be expected to contribute Shs15,000 towards the scheme, with the maximum limit for inpatient services being Shs5 million while the outpatient limit will be Shs1 million. 

Another example shall be dental care services whose limit is Shs300,000, for expectant mothers under C-section, it is estimated at Shs1.5 million while normal delivery is Shs900,000.

The NHIS Bill is still before the Cabinet, waiting for Cabinet ministers and the President to pronounce themselves and have it tabled in Parliament. Once passed into law, government will be able to pool resources to provide affordable healthcare to Ugandans.

Implementing the NHIS will also support Uganda in meeting target 3.8 of the Sustainable Development Goals (SDGs), which aims to achieve Universal Health Coverage (ensuring that everyone can access the health services they need without experiencing financial hardship) by 2030.

If the NHIS is endorsed by the cabinet, the IRA is ready to support, promote acceptance, and facilitate the scheme's rollout, implementation, and oversight, thereby ensuring universal health coverage amongst Ugandans.

While ensuring that healthcare remains affordable for everyone, the Insurance Regulatory Authority of Uganda supports providing financial protection to Ugandans. 

Lastly, in Uganda, where income disparities affect one’s ability to receive quality care, implementing NHIS will promote equity in healthcare by ensuring that all segments of society, regardless of income levels, have access to necessary and at least basic medical services.

 Mariam Nalunkuuma is the manager of corporate affairs at the Insurance Regulatory Authority of Uganda.