NHIMA: Why we need to support it?

Universal Health Coverage (UHC), is top of the global health policy agenda and has been adopted as part of the Sustainable Development Goals (SDGs). Public medical care in Zambia is free or heavily subsidized, which has led to a drop in quality of care given. Lack of medicines, indifferent and uncaring  behaviour by frustrated care givers and health professional the order of the day. Overtime, as the population has grown, it hasn't been possible to fully subsidize the sector. 

In 2018, Zambia passed a national health insurance (NHI) law, creating the National Health Insurance Management Authority (NHIMA). This move towards mandatory health insurance was a significant step towards universal health coverage in Zambia. In this article, we will compare the introduction of mandatory health insurance in Zambia with other public health insurance systems such as ACA, NHS, and NHI, and discuss the pros and cons of NHIMA.

The National Health Insurance (NHI) in South Africa is a health financing system designed to provide access to quality, affordable personal health services to all South Africans, regardless of their socio-economic status. Similarly, the NHS in the UK is a publicly funded healthcare system that provides free access to medical services to all UK citizens. The Affordable Care Act (ACA), also known as Obamacare, is a US law designed to improve the affordability and quality of health insurance in the United States. All three systems aim to provide affordable healthcare for all citizens.

One of the main advantages of mandatory health insurance is that it allows access to healthcare for everyone, regardless of their financial situation. This is particularly important in countries where poverty is widespread, and people cannot afford to pay for medical care out of pocket. In Zambia, the introduction of mandatory health insurance means that everyone will have access to basic health services, regardless of their ability to pay.

Another advantage of mandatory health insurance is that it helps to ensure that the costs of healthcare are shared among the population. This means that those who are healthier and use fewer medical services contribute to the cost of healthcare for those who are sicker and require more medical care. This principle of solidarity is at the heart of all public health insurance systems.

However, there are also some drawbacks to mandatory health insurance. One of the most significant concerns is that it can be challenging to set up and administer. In Zambia, the introduction of NHIMA has required a significant investment in resources and infrastructure to set up the new organization and ensure that it operates effectively. There is also the risk that mandatory health insurance could be used to fund low-quality healthcare services, which would be a significant disadvantage for citizens who are required to pay for the insurance.

Despite these potential drawbacks, the introduction of mandatory health insurance in Zambia is a positive step towards providing universal healthcare coverage for its citizens. The NHIMA has already sent technocrats to learn from other public health insurance systems, such as the ACA, NHS, and NHI. This shows that Zambia is committed to learning from the experiences of other countries to ensure that its health insurance system is effective and efficient.

In conclusion, the introduction of mandatory health insurance in Zambia is a significant step towards universal health coverage. While there are potential drawbacks to the system, the advantages of ensuring that everyone has access to affordable healthcare are clear. It is essential that the NHIMA learns from the experiences of other public health insurance systems to ensure that the system is effective, efficient, and provides high-quality healthcare to all Zambians.