Dr. Steve Manteaw, Campaign Coordinator, Integrated Social Development Centre has suggested that oil and gas companies operating in the country should be engaged and made to contribute to the National Health Insurance Scheme (NHIS).
He pointed out that “even though their operations are offshore, there is no disputing the fact that their flaring, and occasional spills no matter how minor constitute some health risk for fringe communities”.
He said besides, they attract social vices such as prostitution, with its attendant spread of sexually transmitted diseases which might become a burden on the health system.
“A share of the Annual Budget Funding Amount is a way to ensure that majority of the Ghanaian poor also benefit from the country’s oil find,” Dr. Manteaw stated at the 2014 Civil Society Policy Forum of the Universal Access to Healthcare Campaign in Accra.
He said businesses whose activities were known to pose some environmental / public health risks, should be engaged and made to contribute to the NHIS as part of their corporate social responsibilities.
“Currently, mining companies contribute $ 1 and in some instance $ 2 of every ounce of gold produced to community development fund, part of this fund could go to the NHIS as contribution to the health coverage of the beneficiary communities.
“Additionally, health impact should be part of environmental and social impact assessments, and an environmental health levy be imposed on these companies to generate additional inflows to combat malaria, breathing disorders, skin diseases and others associated with mining,” he stated.
“We must seriously consider the imposition of “sin” taxes on alcoholic beverages and tobacco consumption.”
He observed that to phase out or reduce the incidence of out-of-pocket payments at the point of service delivery, “we may want to consider deploying mobile platforms to deduct tokens from calls made by citizens as a way of substituting for the out-of-pocket payments.”
He said we may either treat it as a cross-subsidy arrangement or credit callers as they make calls and offset their out-of-pocket payments with their accumulated call credit.
“In the face of the huge financing gap that confront the NHIS today, as a result of increasing enrolments, we cannot discount the temptation to increase the premium as a “quick fix” to increasing financing, but that will defeat the essence of the NHIS as a social protection programme targeted at the poor,” he said.
He explained that the alternatives should not replace the existing financing arrangements but build upon it; this means Ghana should continue to rely on tax revenue as the bedrock of the NHIS and financed through the budget.
He said “this proposition is premised on citizens’ entitlement under the social contract; efforts should however be made to dilute the regressive forms of taxation, such as the value added tax in the current financing model with more progressive ones such as taxes on luxury goods and consumables”.
This, he said will eventually reduce the regressive tendencies of the current model.
DrManteaw said the role of the state in ensuring universal access to public goods and service was not negotiable, and shifting the responsibility to the private sector amounts to dereliction of responsibility under the social contract.
He said tax offers the best hope of generating the needed extra resources, “but we need to ensure that we go for progressive forms in our bid to achieve equity”.
The Campaign Coordinator said taxes must necessarily be deployed to discourage consumption of goods that impose health-related cost burden on the budget; stating that “we must continue to explore other innovative ways of raising funds for healthcare in Ghana”.