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MEDICAL BILLS FOR EMASWATI TO BE COVERED

05/09/2020 08:58:00 BY TIMOTHY SIMELANE

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MBABANE – The trouble of going after patients who are discharged from public hospitals without paying for treatment, after recovering from an illness, will now be a thing of the past.

Government is at an advanced stage of introducing National Health Insurance (NHI), which will be responsible for indemnifying patients who may not have the luxury of medical aid schemes.

The National Health Insurance (NHI) is a health financing system that is designed to pool funds to provide access to quality affordable personal health services for all emaSwati based on their health needs, irrespective of their socio-economic status.

This is being done against the backdrop of the state losing millions of Emalangeni from patients who don’t pay after recovering. Some of the patients had undergone complicated treatment programmes and had been accommodated in hospitals for several months. However, government says when it’s time for the patients to be discharged, they either neglect payment or plead being broke or at times it is plainly an issue of administrative gaps.

The concern over the non-payment of treatment fees emanates from the Auditor General, Timothy Matsebula’s report for the year 2019, where he states that the owed fees had accumulated to E410 650.00 and that there seemed to be no means to recover the money.

“I am concerned that the ministry is not prioritising to recover the outstanding revenue and I am not aware of any action undertaken towards recovering these debts that have been outstanding over a period of four years. The outstanding revenue should be recovered promptly and should not be written off until all efforts and possible measures have been exhausted,” the AG said.

Liability

Principal Secretary in the Ministry of Health Dr Simon Zwane said one of the reasons patients fail to pay was because there is no means to transfer liability of the patient from the time that they are transferred in emergency from health centres or hospitals to referral hospitals.

Eventually, they leave the health centres without settling their bills.

“Some patients being discharged literally do not have money to settle their bills, but make promises that they will settle the bills at a later date, to no avail; and others deliberately abscond from health facilities without settling their outstanding bills,” he said. Dr Zwane said this week, the process to come up with an NHI had been initiated and was receiving positive feedback from those preliminarily engaged.

He said the ministry had engaged the services of a consultancy firm known as the Oxford Policy Management under the support of the World Bank.

“One of their deliverables was to come up with a draft legislation to establish the NHI. There were certain engagements and consultants on a number of individuals and institutions because when you introduce such a development it is essential to make widespread consultation. These consultations have not been concluded but I can say the response is positive as many people are giving it a nod,” he said.

He said there would be further consultations when the actual legislation is being formulated.

“Many of those we have been consulting have been positive, though they do say “the devil is in the detail.” They will only be definitely positive once the draft legislation has been made,” he said.

The PS said the manner in which the NHI would work was such that it will be able to pool funds from wherever possible to pay for treatment from an accredited health institution.

Purpose,

“The fund has to be properly managed to be able to do its intended purpose,” he said.

He said Eswatini was taking notes from other countries such as South Africa, who are currently at testing phase, in readiness to roll out the NHI throughout the country.

“We have very good examples of countries that have NHI, such as Taiwan and South Korea and Rwanda, who are implementing it. We have good examples on the ground.”

Dr Zwane said the intention was to ensure the process of establishing it was at an advanced stage by now, had the ministry not been impeded by the COVID-19 pandemic.

“If it was according to me, by March next year, we would start to pilot it in Parliament,” he said.

The PS said government was still busy with the Health Bill but was also simultaneously working on the NHI.

The NHI will put the country in a favourable spot to achieve one of the Sustainable Development Goals which is to make health care universally affordable for all.

In South Africa the NHI will be funded through payroll taxes for employees and employers, a surcharge on personal income tax, the reallocation of medical scheme tax credits to the fund and general taxes.