Free primary healthcare policy “repackaged, risks weakening NHIS” — Akwasi Acquah

Former Deputy Health Minister and Member of Parliament for Akim Oda, Alexander Akwasi Acquah, has criticised the government’s newly introduced free primary healthcare policy, describing it as a repackaged initiative that risks undermining the sustainability of the National Health Insurance Scheme (NHIS).

Speaking on the Asaase Breakfast Show on Thursday (16 March), Acquah questioned the foundation and long-term viability of the policy, cautioning against what he described as premature celebration of reforms without clear implementation strategies.

“I think that we want to hasten slowly in the churning out of policies and celebrating them as if we have arrived,” he said.

According to him, Ghana’s pursuit of universal health coverage must be anchored on two key pillars—affordability and accessibility. While the NHIS addresses affordability, he pointed to the government’s unfinished Agenda 111 programme as critical to improving access to healthcare.

He argued that instead of introducing new initiatives, the government should prioritise completing existing health infrastructure projects to expand access to quality care.

Mr Acquah further contended that the free primary healthcare policy duplicates services already available under the NHIS and the Ghana Health Service, including preventive care and community-based outreach.

“What government says it wants to do has already been done. It is just about changing the name,” he stated.

He expressed concern that allowing individuals to access services without requiring active NHIS membership could discourage enrolment and renewal, thereby weakening the scheme’s financial base.

“If all these policies are hinged on health insurance without sustainable funding, you end up suffocating the NHIS,” he warned.

The former deputy minister also raised questions about funding and implementation, particularly whether the country has the financial and human resource capacity to sustain large-scale preventive healthcare interventions.

He noted that while the government has allocated significant resources to the policy, similar investments in completing Agenda 111 facilities would yield broader and more lasting benefits.

Mr Acquah additionally criticised the proposed population-based reimbursement model, arguing that it could undermine accountability and make it difficult to measure the effectiveness of service delivery.

“If I treat five people or 100 people and I am paid the same based on population, where is the supervision?” he queried.

Despite acknowledging the importance of preventive healthcare, he maintained that the policy, in its current form, lacks the data-driven planning necessary for sustainability.

He urged the government to focus on strengthening existing systems, particularly the NHIS, rather than introducing what he described as duplicative programmes.

“This is no new policy. It is an existing system that has been repackaged,” he concluded.