BY ELLENI ARAYA – AUGUST 25,2013
The scheme is one of many such initiatives, along with pension schemes and mandatory third-party car insurance, to soon be implemented
The implementation of universal health insurance has been delayed for six months though it was due to be launched this August. This was relayed through a circular dispatched to all public institutions two weeks ago.
The delay was due to a lag in setting up legal frameworks and operational manuals, as well as in hiring professionals, according to an expert within the Ethiopian Health Insurance Agency.
A proclamation that makes health insurance mandatory for all government employees, pensioners and private employees, at institutions with more than 10 people, was issued on August 19, 2010.
According to the regulation that was issued after the proclamation, those falling under the umbrella of the scheme are expected to contribute three percent of their salaries. This is to be matched by their employers – or the government, in the case of pensioners. Those insured, and their family members, will get ‘essential health services’ and ‘critical curative services’ at selected public institutions, according to the proclamation.
The Ethiopian Health Insurance Agency, which was established in 2010, has the task of implementing the proclamation. This Agency is responsible for collecting contributions and making agreements with health institutions that will provide health services.
So far, however, it has been involved in managing another pilot insurance scheme: the Community Based Health Insurance Scheme (CBHI). This is where communities in pilot regional districts contribute premiums and are then provided with primary health care through public and private health institutions. The poorest 10pc of the communities are covered by the insurance through government subsidies. Currently officials from the Agency are visiting this scheme in the Tigray and Oromia regional states.
For the upcoming employee health insurance scheme, however, the Agency is still in the process of hiring trained manpower. This is one of the primary reasons for pushing the launch back another six months.
The Agency is also preparing a directive that details how payments will be collected. In addition, it is in the process of selecting health institutions that will provide health benefits, a senior official told Fortune.
There are currently 14,416 health institutions in the country, out of which 195 are hospitals. “Since it is a public scheme, government operated health facilities will be the ones selected,” said the official.
Although the scheme provides for both public and private employees, it will only be launched in government institutions, initially. “We will then move on to the private sector,” a higher official within the institution told Fortune.
The universal health insurance programme is one of many mandatory schemes that both the public and private sectors have to implement. Pensions for private sector employees was made mandatory two years ago. Vehicle owners also must now purchase mandatory third party insurance, as of last year.
Source: Addis Fourtune