Officials recommend enrollment for community based and social health insurances
Inpatients getting treatment at federal and university hospitals will have to make advance deposits of projected medical costs in two rounds, initially 40 percent and later 60 percent.
A 100 percent deposit of the projected payment to the inpatient ward is also another option given to patients. It will be applicable on all medical services, except for emergency and maternity inpatients.
With the main intention of generating incomes to the hospitals, the government ratified a regulation last year determining fees to be paid to the hospitals. Since then, the hospitals have been charging higher rates to the patients, but not advance deposits.
Coming to effect beginning July 19, 2022, a directive by the Ministry of Finance clarified about the payment of medical services these hospitals provide, including the need for inpatients to deposit the projected medical costs in advance.
Patients will have to covers costs for bed services, health interventions, nurse cares, food services, medical equipment, and various supplies in these wards. Prices vary depending on the nature of diseases and classes of beds the patients might want to get the services at.
The government hospitals being underfunded and becoming unable to reclaim costs they spend in treating patients are the main reasons for the hospitals to run short of enough facilities and equipment to provide adequate services, as many in the sector claim.
This is the same for Lidiya Tefera (MD) as well, who is a medical service vice provost at St. Paul’s Hospital and Millennium Medical College. Her hospital, along with six others, is under the federal government reporting to the Ministry of Health.
”One of the main objectives for the amendment is to help reduce the financial pressure, even though it won’t solve it totally,” Lidiya said. The income of St. Paul’s Hospital has been growing but it had never been enough to cover its expenses.
She has been observing patients misusing payment free privileges that they get from their local Woreda administration, and the hospital had no way of verifying whether they are actually unable to pay or not.
Moreover, another problem the hospital has been facing is that patients may disappear after initially getting the medical services needed or might not be unable to pay.
Due to all these complications, some hospitals like Lidiya’s could not wait until the directive is issued but start requesting patients for advance deposits of the average payments a few months before its issuance, with the exclusion of those coming with insurances.
“Health financing alternatives such as the community based health insurances have brought changes to these problems. It will soon be either the paying patients or those in the community based health insurances,” Lidiya said.
The government is currently in the process to implement social health insurance alternatives for the working class of the society. It is a move targeted at benefiting from insurance payments in healthcare.
“People need to be enrolled in the insurance schemes and chip in a small amount of money so as to endure the costs,” Lidiya advises.