The Minister of Finance and Economic Planning, Yusuf Murangwa, has disclosed that the government is considering a review of the community-based health insurance (CBHI), commonly known as Mutuelle de Santé. The proposed reforms are intended to enable Mutuelle de Santé to cover drugs at private health facilities. This means that members of the insurance scheme will be able to walk to any private health facility and get access to any drugs, a situation that is currently considered a luxury for only those who are covered by private insurance schemes. This is a welcome move. Mutuelle de Santé covers 90 per cent of the population. The innovative scheme, established in 2003, helps people from low-income access medical care at affordable cost. For instance, household members pay only Rwf3,000 annually to subscribe to the scheme. In turn, they get affordable medical services at any health post or centre, and at any district, provincial and referral hospitals. The scheme even includes the most sophisticated and expensive medical procedures, such as kidney transplant or cancer treatment. Members pay only 10 per cent of the total medical bill. Although the government has struggled to address the underfunding of the scheme and bring more efficiency, it has, from time to time, introduced reforms that have brought some level of sustainability to the scheme. One such reform was to make it mandatory for all formal employees to contribute to the scheme. Currently, all employees in Rwanda pay 0.5 per cent of their net salary to Mutuelle de Santé. Despite these reforms, members of the scheme still struggle to access all medical drugs they need when they go to government health facilities. A trip to any public hospital will show you the plight of Mutuelle de Santé members. Members have to queue in long lines, sometimes spending a whole day at a hospital, just to access medical services. Even when patients get access, there are instances where they struggle to access drugs. This is because public hospitals tend to be overwhelmed due to lack of enough capacity, thereby prioritizing those who are in critical need. Allowing access to private facilities will reduce burden on public hospitals, enable low-income members to access drugs they desperately need, bring efficiency in the scheme, and ultimately democratise healthcare.
