New mutuelle policy: higher fees for increased coverage
Since its establishment, community health insurance has been an extremely effective tool to make medical services accessible for the majority of people. One major problem, however, has been the limited scope of interventions it covers, which has prompted a revision.
Mutuelle subscribers will be assigned to one of three categories. (file photo)
Nadia Mukashema, a 19-yearl-old house worker in Kicukiro, was registered in the mutuelle in Bugesera which she left three months ago to come and work in the capital. She is currently hospitalized in Kicukiro health center, convalescing from injuries sustained in a motorcycle accident a week earlier. And to literally add insult to injury, she has learnt that her health insurance doesn’t cover the treatment she is getting.
“If I had known this, I wouldn’t have paid all that money for the mutuelle,” a desperate Mukashema says, adding that so far she has spent Frw 6000 hospital fees. “They sensitized us to join mutuelle promising we would get free medical services.”
According to Hertilan Inyarubuga, the health ministry’s spokesperson, it is exactly because of the very low annual mutuelle fee of Frw 1000 that not all medical interventions can be covered by the insurance. “Mutuelle de sante was becoming unsustainable, thus inadequately responding to patients’ needs,” Inyarubuga says. “For instance, when you spend 10 days at CHUK for an operation, you will have to pay Frw 130,000. With this new policy we want to adjust things.”
That new policy will result in an increase in annual contributions, but in return health facilities will be better equipped so that patients do not have to be transferred at the slightest complication. In addition, it will extend mutuelle coverage to conditions diabetes, cancer or heart disease. Treatment of severe or urgent cases at King Faisal will also be possible under the new policy.
To make this possible, mutuelle subscribers will be assigned to one of three categories: the well-to-do who pay Frw 7000 per year, the less-well-off for whom the fee is Frw 3000, and the really destitute who will be covered by the government at Frw 2000. These different fees, however, will not reflect different coverage: all three categories are entitled to the same services.
Although the policy officially came into force on July 1, new cards will be delivered only in August since the classification program is still in progress. Assigning people to the categories will be done by the communities at the imidugudu level in a meeting with local authorities.
“After reading the guidelines set by Minaloc, people will assess each other to determine their category,” explains Alex Nkurunziza, the executive secretary of Nyamirambo sector. “If the person in question objects to the classification, it is up to the local leaders to check his situation and make the final decision.”
According to Minisante’s Hertilan Inyarubuga, the classification exercise has been completed for 80%.
Yet some people are still jittery about the new policy, fearing they will not be able to afford it. One of those is Goretti Nakure, a mother of four in Kimironko who earns a living as a hawker. “I heard the explanations about the new program and I understand why it’s done, but I simply don’t see how, as the sole breadwinner, I could afford it for me and my four children,” she says.
Inyarubuga however points out that people should also take into account the increased coverage of mutuelle. “Considering the improved quality of services, the contribution is not too much,” he says. “For instance, a family composed of 5 persons will be required to find Frw 250 per month [per person], which is equal to the price of 2 eggs.”
Moreover, he says that measures will also be taken to allow people to pay the annual fee in installments instead of in one go.
Initiated through pilot projects in 1999, the mutuelle policy was officially instituted and promoted in 2004–2005 resulting in an upsurge in subscribers. Today, it covers over 90 % of the population.
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Posted by Eric Didier Karinganire
on Jul 18 2011. Filed under Flash, National, Weekly Highlights.
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