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Tanzania freezes controversial NHIF rates amid rising discontent

Tanzania freezes controversial NHIF rates amid rising discontent

TANZANIA—Tanzania has postponed the implementation of the new NHIF indicative rates, which was scheduled to begin on January 1, 2024, according to a local dairy,  The Citizen.

This move comes in the wake of rising criticism and a possible boycott threat from private hospitals.

The NHIF announced these changes to the benefit package on December 18th, with the goal of reflecting market costs for some services.

The revisions, however, sparked debate and dissatisfaction among medical professionals and private healthcare facilities who felt excluded from the consultation process.

Tensions peaked when private hospitals threatened to withhold services to NHIF cardholders.

To resolve the concerns and avoid service disruptions Ms. Ummy Mwalimu, Tanzania’s health minister, had an important meeting with members from the Christian Social Services Commission (CSSC), the Association of Private Health Facilities (APHFTA), and the Tanzania Supreme Council (Bakwata).

Following thorough consultations, the Minister of Health issued orders that the new NHIF medical package should not be used until the Ministry releases guidelines following further consultations with the commercial healthcare sector.

Ummy created an independent commission to assess the prices of the NHIF health services package.

The projected reduction in registration and consulting costs for specialist doctors was the main source of disagreement. Maintaining their services under the new packages may prove difficult.

Private hospitals objected to the revisions, noting the high costs of running their facilities, which could jeopardize the quality of services provided.

Although the updated package aims to add 124 important pharmaceuticals to the covered list, alleviating the strain on NHIF members, the pricing modifications include discordant aspects, demonstrating that balancing affordability with healthcare remains a struggle.

Furthermore, APHFTA has expressed worry about payments that are more than three months late and unusually substantial deductions (5 to 40% of the monthly bill) that are made without sufficient verification, putting financial hardship on private health institutions.

The association also opposes the numerous fees paid in the healthcare industry, some of which contradict Prime Minister’s Office orders via the “BLUE PRINT.”

The Private Hospital Advisory Board (PHAB) and the Private Health Laboratory Board (PHLB) are to be united under one registrant by 2022, according to the Blue Print. Efforts are being made, however, to keep PHLB alive, which is increasing the financial load on health facilities.

The imposition of a new ultrasound price on non-radioactive portable devices by the Radiation Board (Tanzania Atomic Energy Commission, TAEC) has also garnered criticism from APHFTA, which believes the tax is unwarranted and will raise the cost of treatment, particularly for pregnant women.

Stakeholders are also concerned that the new NHIF packages have marginalized the private sector, which has been at the forefront of technological innovation and quality of care, with fears that some private hospitals will withdraw from NHIF, putting an additional burden on public and FBO health facilities and widening the access gap.

Stakeholders further note that the NHIF was founded as a “social solidarity fund,” not an insurance corporation, and that recognizing commercial hospitals as service providers has altered how the NHIF card is seen.

While this has increased the number of services available to NHIF members, it has also resulted in difficulties such as fraud and overuse of services.

As a result of the suspension, the NHIF and stakeholders have an opportunity to engage in an open conversation to ensure that the amended packages address the concerns identified, promote the corporation, and enable smooth health access.

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