Role and Impact of Health Insurance in the Health Delivery System
Health insurance is one of the types of insurance coverage that covers the cost of an insured individual's medical and surgical expenses or bills. Depending on the type of health insurance coverage, either the insured pays costs out-of-pocket and is then reimbursed, or the insurer makes payments directly to the provider. In health insurance terminology, the "provider" is a clinic, hospital, doctor, laboratory, health care practitioner, nurse (midwife) or pharmacy. The "insured" is the owner of the health insurance policy; the person with the health insurance coverage. In countries without universal health care coverage, such as the USA, health insurance is commonly included in employer benefit packages and seen as an employment perk (Nordqvist, 2012).
In the midst of increased cost of health care both at the macro and micro levels, health insurance becomes a viable alternative for financing health care in Ghana. It is also a way of mobilizing private funds for improving health care delivery at the macro level. A number of countries are currently experimenting with different approaches. Ghana's National Health Insurance Scheme (NHIS) was passed into law in 2003 but fully implemented from late 2005. It has already reached impressive coverage levels (Witter & Garshong, 2009).
The health system in Ghana before the introduction of NHIS was being financed by what was known at the time as the “cash and carry system” of health delivery. Under this system, patients – even those who had been brought into the hospital on emergencies – were required to pay money at every point of service delivery. Imagine being sent to a hospital with a bleeding accident wound and being asked to pay before a doctor attends to you. A lot of people died because of the cash and carry system. In some cases, lives were lost for