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Finance Minister outlines plan to fix gaps in Mutuelle de Santé

The Minister of Finance and Economic Planning has said that recently-approved subsidies will help the government to fix the growing funding gaps that have been affecting the community-based health insurance scheme – Mutuelle de Santé. Minister Uzziel Ndagijimana made the observations while appearing before the plenary sitting of the Parliament’s Chamber of Deputies on Tuesday, July 7, 2020, to give explanations for outstanding expropriation compensations, and arrears owed by the Mutuelle de Santé to health facilities among others. In their health service assessment tours made in January and February 2019, members of parliament found outstanding bills owed to health facilities including hospitals and health centres, which hampered service delivery at these facilities. They also found that there are medical bills which are not paid on time, an issue they said has adverse effects on health service provision to patients such as lack of drugs and medical equipment. Parliament wanted the Minister of Finance to provide a clear roadmap to completely clear arrears owed by the Community Health Insurance Scheme to health facilities. Ndagijimana said that from 2003, the Government of Rwanda established the community-based health insurance scheme policy in a bid to help people with low income get healthcare. Since then, he said, this health insurance has greatly contributed to Rwandans’ access to healthcare. The Government pays the contribution that should be made by the most economically vulnerable citizens. However, the Minister said that the cost of health service to Mutuelle de Santé affiliates was higher than the contributions they make, as well as the financial support by the Government to the insurance scheme.   The situation, he said, resulted in the increase of arrears owed by the community-based health insurance to hospitals and health centres. Growing gaps, and means to fill them Ndagijimana said that Mutuelle de Santé arrears increased from Rwf12.8 billion in 2015/2016 to Rwf24.5 billion in 2018/2019, pointing out that Rwf67.2 billion in four consecutive fiscal years beginning from 2015 to 2019. He said that the Government found ways to fill those gaps such that the Ministry of Finance pays all the due money. However, he said that there is a gap of Rwf20.6 billion that Mutuelle de Santé faced in the 2019/2020 financial year that concluded in June, which is still uncovered. He pointed out that though the Government looks for ways to fill such gaps, the issue caused delays in paying medical bills for services offered by hospitals and health centres. Meanwhile, the minister said that in order to address the inadequate funding for the scheme, government devised a strategy to increase its financing through subsidies provided for by the Prime Minister’s Order of February 13, 2020. “It is expected that the new subsidies to Mutuelle de Santé will generate an additional Rwf27 billion per year, which might increase as time goes by because some of the avenues are likely to grow such as those from telecommunications, petroleum products, and car inspection,” he said. “That money is more than the gap we registered last year (in 2019/2020). We hope that it will fill it,” he said. MP Jean-Pierre Celestin Habiyaremye said that when arrears are carried into another year, they become a hindrance to the operations of an institution, wanting to know how the medical bills of hospitals are considered in the national budget.  “If people do not get the medication they need, the health facilities will not be helpful to them,” he said, suggesting that paying hospitals and health centres should be priorities especially for those health facilities that were built at borders. MP Aimée Sandrine Uwambaje said that there should be effective long-term measures to address the delays in paying health facilities for the services they provided to patients who are subscribers to Mutuelle de Santé.

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