Achieving a Shared Goal: Free universal healthcare in Ghana

Publication date

09 Mar 2011

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The current health system in Ghana is unfair and inefficient. It doesn’t have to be. The government can and should move fast to implement free health care for all citizens. The findings in this report include: Coverage of the National Health Insurance Scheme (NHIS) has been hugely exaggerated, and could be as low as 18%. Every Ghanaian citizen pays for the NHIS through VAT, but as many as 82% remain excluded. Twice as many rich people are signed up to the NHIS as poor people. 64% of the rich are registered compared with just 29% of the poorest. Those excluded from the NHIS still pay user fees in the Cash and Carry’ system. Twenty five years after fees for health were introduced by the World Bank, they are still excluding millions of citizens from the health care they need. An estimated 36% of health spending is wasted due to inefficiencies and poor investment. Moving away from a health insurance administration alone could save US$83 million each year. Enough to pay for 23,000 more nurses. Through savings, good quality aid but primarily improved progressive taxation of Ghana’s own resources, especially oil, the government could afford to increase spending on health by 200%, to US$54 per capita, by 2015. This would mean the government could deliver its own promise to make health care free for all - not just the lucky few at the expense of the many.