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Law to improve Mutuelles de Sante in offing

Saturday October 25 2014
RTHEALTHINSURANCEa

The health insurance card, commonly known as Mutuelles de Sante. PHOTO | CYRIL NDEGEYA | NATION MEDIA GROUP

The government is pushing for a tougher legislation to help tackle decreasing subscriptions and accumulation of debts in the country’s Community-Based Health Insurance Scheme (CBHI), commonly known as Mutuelles de Sante.

The proposed law seeks to transfer the responsibility to collect premiums, in the hands of the Rwanda Revenue Authority (RRA), the government agency responsible of collecting and accounting for tax. This comes after the health insurance scheme was moved from the Ministry of Health to Rwanda Social Security Board (RSSB) this year for better financial management.

Premiums were supposed to be collected by local authorities and paid to hospitals through the ministry but “this was not always the case,” the government says. RSSB, which recommended the change, is confident that the new method will improve the collection of CBHI contributions.

“RSSB is working with RRA in collecting pension premiums and this has proven to be positive, and we believe the same will happen to CBHI,” said Dr Daniel Ufitikirezi, the Director-General of RSSB.

A comparison of four consecutive years has shown a decrease in the adhesion to the scheme. An estimated 73 per cent of Rwandans subscribed to it in the last fiscal year 2013/14, down from 80.7 per cent and 90.7 per cent in 2012/13 and 2011/12, respectively.

READ: Report praises Rwanda’s health scheme

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Analysts believe the success of CBHI under RSSB will largely depend on the ability of the organ to effectively mobilise contributions to the scheme. This, they say , will require hard work to ensure that due contributions are paid in time and putting in place an effective and efficient enforcement mechanism for those not complying.

“This task is incumbent to the Ministry of Local Government and the Ministry of Health,” Dr Ufitikirezi said.

Sanctions

The Bill, which has been tabled in parliament, provides for a mobilisation committee in each cell and proposes financial sanctions that may be double the premium a subscriber failed to pay because of what is deemed reluctance.

Some lawmakers expressed concern over this penalty, saying it contravenes the principle of voluntary adhesion to the scheme.

The Mutuelles de Sante policy is designed in a way that its members can access healthcare at all public and non-profit health centres in Rwanda but the package does not include coverage at private health centres or private pharmacies.

CBHI members interviewed by Rwanda Today confirmed that on most occasions they did not get the medicines prescribed at public health facilities.

“Pharmacists at the hospitals tell us that the drugs are out of stock, advising us to buy them at private pharmacies,” said Emile Karangwa, a resident of Gasabo.

In such a case, patients are obliged to buy drugs outside the health centres and hospitals, yet they are covered.