Thursday, October 28, 2021

Gov’t limits medical coverage for alcohol related cases

Government has introduced health policy that denies medical coverage to people who got injured during alcohol related activities including those associated with suicide and lung cancer.

President Ian Khama’s disdain for alcohol hit a record high recently following a decision by the government to deny medical coverage for injuries related to alcohol in all health facilities across the country.

The Ministry of Health and Wellness has already been instructed to exclude those who get injured due to alcohol and drug related activities from medical coverage.

This is contained in a savingram from Ministry’s Permanent Secretary Shiraz El-Halabi dated 29 March 2017, titled “Removal from medical cover for self-inflicted harm” addressed to District Health Management Team (DHMT) heads.

The savingram states that the implementation of removal of medical cover for self-inflicted injuries will be on:

  • Drunk driving                                     
  • Riding motorbikes without helmet
  • Failure to use seat belts for self or children as passengers
  • Participation in riots and mass gatherings involving violence leading to injury
  • Lung cancer associated tobacco and tobacco products
  • Attempted suicide related to alcohol or drug abuse

El-Halabi states that “It has become increasingly clear that the cost of sustaining medical services has continued to escalate and, while a new health financing strategy which will articulate various health funding modalities is being developed, it has been decided that some services given in some segment of our patients will now have to be paid for.”

Complete with guidelines, the savingram identifies areas that will be charged in all our health facilities with effect from 1st April. 

“It is envisaged that the current ministry of health tariffs in use shall be applied for this purpose in all aspects of clinical care.”

The savingram further states that “All heads of DFMT) are expected to assume full responsibility for the implementation of this initiative and be reporting to the permanent secretary on quarterly basis.”

According to the guidelines of the document, own behaviours, actions, and decisions , health insurance policies have been amended to exclude cover for self-inflicted injuries.

The guidelines further state that if self-injury occurs as a result of a pre-existing illness such as depression the cover is stipulated to exclude rehabilitation.

El-Halabi explains that the fundamental principle behind the removal of medical cover on self-harm is that those responsible for causing injury to themselves should meet the medical cost of their treatment. The costs include the recovery of the ambulance journey costs.

The day to day collection of the money will be administered at the point of treatment. An invoice capturing the details of the treatment cost will be made available to the patient.

“This should include costs of the ambulance if the patient arrived by ambulance. This will assist in calculating how much will be payable. A 50 percent deposit may be required before treatment is administered,” reads the document that outlines the guidelines.

On costs associated with area or location, the document stipulates that people will be charged for “inpatient costs, hospitalization, cost of investigation, treatment, transport food and related costs.”

Outpatient costs include among others, cost of investigation, treatment and other related costs

With regard to rehabilitation, travel costs, rehabilitation charges, appliance and other related costs will be charged.

The document also reveals that patients “will also be charged for legal costs, resources for appeal cases.”

It not clear what could have necessitated the latest development but observers see it as part of President Khama’s modification of the alcohol levy which he introduced upon assuming office in 1998. The levy currently stands at more than 55 percent.

El-Halabi’s mobile phone rang unanswered on Friday. 

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