The Ministry of Defence on June 6, tabled before Parliament a bill that seeks to make the Military Medical Insurance (MMI) a specialised organ. 

While explaining the relevance of the bill, Maj Gen. Albert Murasira, the Minister of Defence said that this will allow the scheme to have the necessary autonomy for better healthcare provision to its members.

"The statute of specialised organ will allow MMI to have the necessary autonomy in terms of recruiting and managing its staff and determining the procurement rules to achieve its mission,” Murasira told parliamentarians.

According to the explanatory note of the bill, since its establishment (in in 2005) MMI activities have been consistently growing. Initially, its members were Rwanda Defence Force (RDF) personnel and eligible dependents only.

Currently, members of other security organs and their eligible dependants have been on-boarded. 

They include the Rwanda National Police (RNP), National Intelligence and Security Service (NISS), public institutions like Ministry of Defence (MoD), Rwanda Investigation Bureau (RIB), Rwanda Military Hospital (RMH), Armed Forces and Rwanda National Police Shop (AFOS).

Others are the MoD affiliated agencies such as Horizon Ltd, Zigama CSS (Credit and Savings Society), Mediasol (group of pharmacies affiliated to MMI).

In addition to its mission of managing medical insurance for its beneficiaries, MMI also has the mandate of investing funds in order to guarantee the financial stability and sustainability of activities under its responsibilities, added the explanatory note.

As an insurance institution, MMI is a financial institution subject to the regulations of the Central Bank. And, currently, the recruitment of the scheme staff involves the approval of the Ministry of Public Service and Labour.

Murasira said that for MMI to better achieve its objectives, it should have the latitude to makes decisions in a swift manner, and the best employees on the market, something that cannot be done because they are strained by public service regulation.

He gave an example saying that as the institution grows, there is need to have the best actuarial scientists on the market, something that cannot be done because of their current salary scale.

To address these concerns, the bill proposes that MMI should operate as a specialised organ and be given greater autonomy in the management of its assets and personnel, in order to operate more efficiently.

MPs’ observations

MP Jean-Damascene Murara raised the concern that the Rwanda Correctional Service (RCS) indicated that its staff cannot get medical services under MMI.

"This is a recurrent issue. Why isn’t their request being granted or not, instead of saying that it is being considered for years. I think there is a need to make a definite decision on that,” he observed.

MP Therese Murekatete said that there has been an issue where MMI works with few pharmacies in the country, yet, it has a large number of  members, which requires the increase of the number of pharmacies that partner with it.

For instance, she said that in Musanze District, there is only one pharmacy that works with MMI, yet, the area has key security installations like the RDF Command and Staff College, and the National Police College in Musanze with many members.

"I wonder whether this autonomy will result in the increase in the number of pharmacies that work with MMI in order to facilitate its members for improved medical service delivery,” she remarked.

Responding to MPs’ points, Murasira said that all Rwandans, including civilians are allowed to join MMI, but they have to meet the contribution threshold, which is where the challenge lies.

The minister said that contributions are currently based on a member’s gross salary, where the staff member to contribute 3 per cent plus a 17.5 per cent subsidy from government.

"For RCS, the issue is that they need to have the 17.5 per cent [support] from the Government budget. If they secure that, they will become members,” he said.

He said that MMI works with one pharmacy – Mediasol –agreeing that they have to work out a plan such that members can get treatment or get medicine with convenience.

Mediasol has four branches, three of which are in Kigali, and one in Musanze District, Northern Province and Murasira said that they would look at opening up more.