Tanzania: Universal Health Bill Sails Through

  • Establish special fund to finance the poor, chronic diseases
  • New arrangement for people to access services across the country.
  • Private sector can opt for any scheme, be it public or private.
  • Removed all treatment exemptions
  • Every Tanzanian will be required to enroll into the scheme

The National Assembly unanimously endorsed government bill to attain Universal Health Coverage (UHC) on Wednesday.

The government had proposed six main measures to finance over 15.8 million poor Tanzanians (around 26 per cent of the population) so as to attain UHC.

The sources include service levies on carbonated drinks, liquor, cosmetic products, betting, motor vehicle insurance fee and through electronic transaction levies.

Financing health expenses for the poor was among the key issues which were raised when the Universal Health Coverage Bill was tabled for the first reading in Parliament.

Tabling the UHC Bill in the National Assembly on Wednesday, Minister for Health Ms Ummy Mwalimu noted that due to the magnitude of the matter, all considerations and recommendations that had earlier on hampered the process of endorsement of the Bill has been keenly dealt with attracting the many amendments.

Appearing for the second and third reading, the much-awaited bill is being looked at by the public as the answer to help many Tanzanians, especially the most vulnerable to access health services.

Ms Mwalimu indicated that the government has suggested establishment of a special fund which will settle the cost of health insurances for vulnerable groups in the country.

According to her, a special mechanism will be employed in the identification and registration of people who do not have the ability to pay for the insurance. The group will be included under the public health insurance scheme as stipulated in the guidelines.

“In accordance with the Bill every Tanzanian will be required to enroll into a health insurance scheme to ensure people obtain medical services without any challenges even at challenging times.

“The government will employ statistics from the Household Budget Survey of 2017/2018 which shows that 26.4 per cent of all Tanzanians are poor. In accordance to the statistics, the Population and Housing Census of 2022 indicate over 15.8 million comprise of vulnerable groups which is equivalent to over 3.6 households and those living in abject poverty stand at over 4 million people (8 per cent) accumulating 1.1 households,” said Ms Mwalimu.

She noted that the government will also effectively supervise the matter in ensuring poor people have access to quality health care.

Besides, the Minister revealed that the special fund will be used to facilitate medical services for people suffering from chronic and lifetime diseases like kidney complications, cancer as well as emergency services resulting from accidents.

In line to this, she said the scheme has given directives for insurance schemes to offer a Standard Benefit Package to its beneficiaries. The package equally gives room for beneficiaries to obtain additional benefits which cannot be accessed in the primary package. The goal is to ensure every citizen access basic services obtained in the Standard Benefit Package.

In arriving at the goal of Universal Health Coverage for all while recognising the critical investment done under the Community Health Fund (CHF), the Bill has suggested for CHF to be repealed and be replaced by introducing a Community Health Insurance Package (CHIP).

She observed that the aim of introducing the package is to ensure all citizens are incorporated in the health insurance plan to enable provision of quality services without facing challenges.

Among challenges that were considered include not accessing services out of the area of registration, its few services in nature and voluntarism.

In the area of dependents, the Bill has outlined a total of six beneficiaries including the contributor, spouse and four children including biological, adopted and step children.

Equally, it requires employers from both the public and private sector to enroll its new employees within 30 days after the start of the contract.

As for the contributions, the Bill has amended the required section, whereby employers from the public sector will contribute six percent and those from the private sector who have opted to register its employees in the public health insurance scheme.

On the other hand, freedom has been given to employers of the private sector to opt for any scheme be it public or private.

Similarly, Ms Mwalimu said the Bill has removed all treatment exemptions and the questions of preventing patients or bodies from being discharged for lack of settling individual’s medical bills.

Again, in putting forth a good regulatory framework in managing health insurance in the country, she said the Tanzania Insurance Regulatory Authority (TIRA) has been mandated to perform the role.

Among its critical roles will be to carry out the registration health insurance schemes offer Standard Benefit Package as well as give standard guidelines of their operations.

However, a 10 per cent fine will be channeled to all individuals who will not enroll into any insurance scheme within three years from the commencement of the law.

Relating to the Toto Afya Card, the Minister said the Bill does not comprise the package, noting that the majority of the children enrolled there 99 per cent were sick.

With this regard, she said the mechanism of health insurance involves cost sharing.

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