Friday, June 2, 2023
NewsFund diversion concerns prompt health insurance audit

Fund diversion concerns prompt health insurance audit

– Two woredas in Hadiya Zone under investigation

– They are allegedly exploiting health insurance funds for salary payments

A nationwide audit will be carried out soon to determine whether the health insurance premiums collected from citizens are utilized for the intended purpose.

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It is an initiative taken in response to growing concerns that premiums collected by Woredas, the lowest government organ, are being misused, sending shockwaves through the entity in charge of establishing an efficient health insurance system, the Ethiopian Health Insurance Agency.

Parliamentarians voiced their displeasure with certain Woredas on May 3, 2023, claiming that in some cases, they were utilizing the collected premium to pay the salaries of public servants.

“Premiums collected from citizens are supposed to be used to pay health expenses incurred by policyholders, but we have received reports that they are being used to pay salaries,” said Nebyat Tilahun, member of the parliament’s standing committee on Health, Social Development, Culture, and Sport Affairs.

Another legislator shares her concern.

“This must end because it is unlawful,” said Werksemu Mamo, head of Health, Social Development, Culture, and Sport Affairs.

Currently, 56 million Ethiopians are covered by the government-run health insurance system. It is a community-based insurance system in which policyholders who buy insurance from Woredas receive a health treatment for free, with the government having to reimburse the balance depending on an agreement struck with the health service provider.

Citizens from both rural and urban areas are eligible for the service. Currently, 80 percent of policyholders live in rural locations, with the remainder living in urban areas. While the Agency is in charge of equipping lower authorities in order to increase their collection capacity, the pool that is currently being collected is disorganized and not centralized.

“Almost every woreda has its own account for health insurance, but this has decentralized the pool and made management difficult,” said Gudeta Abebe, the Agency’s director in charge of mobilization and budget oversight.

There are currently 980 woredas collecting health insurance premiums.

“Only a few regions organized the Woredas and took steps to consolidate the premium collected by various entities into a single account, thereby centralizing the resource collection system. This reduces the possibility of resource diversion,” Gudeta explained.

There are already woredas being investigated for budget diversion. This follows the Parliament’s concern over the use of the premium collected from citizens.

“We sent a team to investigate if the Woreda used the money to pay salaries,” Gudeta added.

Recently, woredas, primarily in the South Nation Nationalities People and Amhara regions, have been in hot water after experiencing a serious budgetary crisis, even to the point of being unable to pay employees for more than two months.

Contributed by Abebe Fekir

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