There is a need to fast-track the establishment of new tariffs to address the pressing issue of financial hardships negatively affecting health facilities, the Rwanda Private Medical Facilities Association (RPMFA) has appealed, again.

Dr. Savio Dominique Mugenzi, the Chairman of RPMFA, told The New Times, on Friday, October 11, that the new medical tariffs are long-overdue.

The RPMFA, he said, is still waiting for the Ministry of Health to set the new tariffs to address issues.

The RPMFA is an umbrella organisation that brings together private health facilities in Rwanda. The hospitals, polyclinics, general clinics, and specialised clinics under the umbrella are currently estimated at around 200.

The current tariffs took effect in 2017 and were supposed to be used for only one year, after which they would be adjusted accordingly – in 2018 – RPMFA indicated, but they remain unchanged despite the ever-rising cost of living, among others.

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The delay in setting tariffs that factor in the current market price realities does not only affect private medical facilities, but also public ones.

However, private medical facilities bear the brunt of the issue because they do not receive allocations from the national budget for them to be able to pay healthcare workers or run other recurrent expenses such as on electricity and water, as the public ones do.

"The fact that we are still using tariffs set in 2017 makes us incur losses because the fees do not match the current situation,” Mugenzi said, adding "we have difficulties paying workers.”

"We want the tariff [current one] to be revised as soon as possible,” he said, expressing concern over the fact that the ministry keeps pushing back the setting-up of the new health service fees.

Healthcare workers’ pay rise, and increase in medical equipment

According to RPMFA, private medical facilities were grappling with increased operating cost, including paying higher salaries to healthcare workers – as their pay rose in relation to the increase in the cost of living, and the declining value of the Rwandan franc.

Also, the association is concern that the costs of medical equipment and other related products went high, yet the money patients pay for services performed by using the same tools did not increase.

Data from RPMFA shows that the average salary of a senior specialist doctor was Rwf1.5 million in 2017, but it doubled to Rwf3 million in 2023, while that of a registered nurse rose by 40 per cent, from Rwf250,000 to Rwf350,000.

A minicap hemoglobin [one kit] saw its price soar to Rwf600,000 in 2023, from 189,600 in 2017, implying a more than two-time increase. Minicap hemoglobin is designed for examining hemoglobin – the protein contained in red blood cells that is responsible for carrying oxygen from lungs to tissues and organs in the human body.

Other equipment whose prices went up, as per the data, include a Minividas Immuno analyser (fully automated) – used for analysing antibodies and antigens in blood samples – which cost was Rwf14.5 million in 2023, up from Rwf11 million in 2017, representing an increase of 31 per cent.

On May 21, the Ministry of Health promised that a comprehensive revision of medical tariff was set for completion in June to help address the financial concern of medical facilities.

But, in August, the Permanent Secretary at the Ministry of Health, Zachée Iyakaremye, told The New Times that the review of the tariffs was still under discussion by all concerned entities. The stakeholders include health facilities and medical practitioners, to make sure that all medical services or procedures are covered, and health insurance companies, to see whether the tariffs being proposed are realistic, as well as the Ministry of Finance and Economic Planning which oversees the insurance sector.

However, Iyakaremye could not specify exactly when new tariffs could be approved and issued for application, after the previous timeline was not met.

The New Times was not able to get a comment from the Ministry of Health regarding the awaited new tariffs.