The Untold Story of Risk Pooling in Ghana's National Health Insurance

The rising cost of health care financing the world over in the 1980s led to a paradigm shift in health care financing, from point of service; user fees; out- of- pocket- payments otherwise referred to as 'cash and carry', to prepaid systems and for that matter health insurance as an alternative health care financing system. Health insurance is said to be an efficient and effective system which ensures the provision of accessible, affordable, equitable and quality health care services to a majority of people, especially the poor and vulnerable, hence, its adoption by the Government of Ghana as part of its poverty reduction strategy in 2003. Even though a good health financing system, the implementation of health insurance has posed a lot of challenges with respect to its technical design, managerial capabilities, organizational and institutional arrangements. The study therefore finds out whether the health insurance scheme and its implementation is capable of ensuring adequate risk pooling and sharing, efficient management for sustainability, and the achievement of the Millennium Development Goals 4 and 5 on health.