Mr Speaker, I have not asked you to take part. I am only saying something that is of factual basis.
Now, we all agree that there is a legal basis; we also agree that the reasons and the benefits or the beneficial effects of capitation are very clear. One, it is about the sustainability of the whole scheme and the cost containment of it. It also means that you have to ensure that whereas people were just going to any facility, and a patient could go to about three facilities in a day if wished, now, once you are enrolled with one provider, you are required to go to that provider only.
After that, if you think that the provider is not satisfying your needs -- for instance, if you advertise the place as a hospital, and I enroll as a subscriber, only for me to go and meet ward-aids, and nurses taking care of me, I would “pot” as we do in the telephone business. When one provider is not doing what you expect, you go to another one.
Therefore, it would also introduce managed competition among providers in this case. It also enumerated a number of things connected with claims.
Mr Speaker, once you have a claim, and it should always be predetermined, you are helping the provider in some cases to improve upon the conditions of that facility to be able to maintain the kind of clientele coming to that provider.
Above all, it eliminates what we call fraud in the claims. It has to be human beings who come to the clinic, who get the treatment or go to the pharmacy shop of any of the providers before you can claim the money that is advanced to you. If, as I said, we do that, it will help us cut down all the expenses that were being incurred by the Scheme and are trying to break down the Scheme.
The other payment mechanisms were still available; one important fact is that, it did not affect in-patient care at all. It was provided.
There are challenges that we should talk about in the implementation. Since there has not been any benchmark practice before, it is of no doubt that in implementing it, you will face difficulties. What are the difficulties?
One of them is the fact that even though the National Health Insurance Authority (NHISA) promised to pay one week in advance of the start of the treatment, in some cases, the rural areas, they did not have bank facilities to be able to access this money. Of course, there is always a delay in making that payment.
The rate was contested by the providers and the National Health Insurance Authority has written to the providers to explain and also to re-adjust to the rates that are not totally satisfactory, but rates that they could cope with. In doing all these things, we are doing it because of the patients, the provider and the Scheme. Therefore, if there are challenges, what is important for us, is to
look at how we would resolve the problem. Should we go back? No! It has worked in other places perfectly well and we should as a country also invest in it. We are not arguing about the benefits at all. What we are arguing about, sometimes, is about the fact that it was being implemented in one region.
Mr Speaker, I can say that having all the concerns that were raised, the National Health Insurance Authority, in a number of ways, tried to visit, have discussions. Incidentally, I was also the Minister at the Ministry of Health at the time of the implementation and I had the opportunity to go to the Ashanti Region to follow up on the concerns that were coming.
I believe that the Ministry, together with the Authority, can resolve the problems.Therefore, it will be good after the review, to extend it -- as I hear or I understand, the authorities want to do that to three more regions -- Upper East, Volta and Upper West Regions.