Private companies that offer insurance services have expressed mixed feelings over government’s plan to raise their current contribution to the community-based health insurance scheme, commonly known as Mutuelle de Santé.

Talks are ongoing between government and private insurance firms to have the latter raise their current contribution to Mutuelle de Santé from the current 1 per cent of their annual premiums to 5 per cent.

While officials at the Ministry of Health say the increase would improve the quality of healthcare services that the country’s poorest get through Mutuelle de Santé, some managers of private insurance companies said 5 per cent of their premiums would be too much.

The discussions are being held as a new law governing the organisation, functioning and management of health insurance schemes in Rwanda is before the Senate.

Apart from specifying that contributions for Mutuelle de Santé will be paid on an individual basis, a draft of the new law proposes that "other sources of contributions to community-based health insurance schemes shall come from commercial health insurance schemes and public health insurance schemes.”

Previous drafts of the Bill had specified that public and private insurance schemes pay 5 per cent of their premiums to Mutuelle de Santé but legislators have left it to government to specify in a ministerial order the rate of the contribution.

Joseph Bahenda, the managing director of the Compagnie Rwandaise d’Assurance et de Réassurance, Assurance Générales (Corar AG Ltd), said Mutuelle de Santé should also be the responsibility for other profit-making corporations.

"It should be a national effort. Even if you charge us 10 per cent of our premiums, it won’t solve the problem,” he told The New Times.

While Bahenda admits Mutuelle de Santé helps improve the quality of healthcare for the average Rwandan and give a positive impact on his company’s business, he does not agree with targeting insurance companies as the only private corporations to contribute to Mutuelle.

"It’s not fair to have this thrown at insurance companies only. I am ready to contribute, but why can’t this be everyone’s responsibility?” he asked.

Marc Rugenera, chief executive of Radiant Insurance Company, also agrees with the principle of having private health insurance companies contribute to Mutuelle de Santé but not at the 5 per cent rate of their premiums, proposing 3 per cent.

"The benefit for insurance companies is that in case Mutuelle de Santé works better, fraud cases among clients of private insurance companies seeking to put non-bona fide dependants on their plans would go down,” he said.

Rugenera added that giving to Mutuelle de Santé is a good way for insurance companies to fulfill their corporate social responsibility.

Another proposal in the Bill is to make health insurance in Rwanda mandatory for every resident.

Client base

The draft law proposes that "any person who arrives on the Rwandan territory without health insurance coverage that is valid in Rwanda shall be required to join a health insurance scheme of their choice within a period not exceeding 30 days.”

The insurers say making health insurance mandatory in the country would increase their client base because more tourists, consultants, as well as Rwandan workers who would skip buying health insurance will no longer have that option.

"It means that insurance companies will have more subscribers, which is likely to bring down the cost of our health insurance premiums and hence improve our ability to deliver quality services to more people,” Rugenera said.

Dr Louis Kitoko Mbuguje, director of medical insurance at Soras insurance company, agrees that making health insurance mandatory for everyone in Rwanda is good because it will help in sharing the burden of paying for healthcare and thus improve the sector.

"It’s a very good thing for Rwandans in general and the medical insurance industry in particular. It will definitely increase the number of our subscribers; the more they are, the more they share the burden of paying for their healthcare through decreased premiums,” Dr Kitoko said.

The president of the Senate Committee on Social Affairs, Thérèse Kagoyire Bishagara, told The New Times that her committee will consider views of different people before passing the law.