Raymond Ozoji, Awka
Anambra State Health Insurance Scheme, a comprehensive health care package introduced by Governor Willie Obiano to enable citizens to enjoy unhindered and uninterrupted access to subsidized quality health care services across the state, has blacklisted three health facilities in the state over sharp practices.
The scheme since inception is said to have reduced mortality rates and increased access to more elaborate health care especially in the hinterlands where rural dwellers grapple with low income.
The health insurance scheme being championed by the Anambra State Health Insurance Agency (ASHIA) has through its public enlightenment campaigns enrolled over 90,000 subscribers currently enjoying access to comprehensive health care services across the state at little or no cost.
But in spite of this state government largese, some hospitals used for the health insurance scheme seemed to have negated the aim of the scheme and indulged in sharp practices thereby short-changing and over-charging beneficiaries of the health insurance scheme contrary to its original essence of providing subsidized health care for citizens. This situation has however led to the sanctioning of three hospitals under the scheme.
Executive Secretary of the Anambra State Health Insurance Agency and Special Adviser to Governor Willie Obiano on Health, Dr. Simeon Beluonwu Onyemaechi, said ASHIA as at the time of speaking with our correspondent at the headquarters in Awka, has close to 90,000 enrollees from both the formal and informal sectors.
He said that the beauty of the scheme was that over 30,000 enrollees were from the informal sector, stressing that the informal sector and health insurance were a big challenge in the country even though he pointed out that ASHIA has demystified the said notion through what he identified as the adoption model.
He said ASHIA ensured quality and also made sure that health care providers did not render substandard services to enrollees and defeat the aims and objectives of the scheme.
According to him, three hospitals have been suspended this year amidst the COVID-19 pandemic for sharp practices meted out on subscribers of the state health insurance scheme. He said the scope of the scheme covered primary, secondary and tertiary health care services.
The ASHIA boss further disclosed that Anambra State Health Insurance Scheme was the only health insurance scheme in the country that covered tuberculosis especially for HIV patients and other major treatments in spite of their capital intensiveness.
He said , “We have had situations on daily basis where people will call in and say I went to this hospital and I was short-changed. We investigate such with supporting documents and what we do is to deduct that amount from the money we pay the hospital and credit the account of the enrollee with the amount he was over-charged the same day.
“Once you are over-charged or short-changed for services you shouldn’t have paid for because ASHIA covers it, we reinburse the enrollee and deduct it from the hospital.”
He said those were the kind of measures taken that had actually boosted the confidence of the people and their firm belief in the workings of the Anambra State Health Insurance Agency.
Although he emphasized that the names of the three hospitals sanctioned for sharp practices against subscribers of the state health insurance scheme won’t be mentioned in print for operational reasons, he charged health care providers in the scheme to abide by the service level agreement signed with ASHIA and refrain from such unethical practices.