Dear President Museveni. We request you to let us pivot the National Health Insurance Scheme into the National Job Creation Fund to create jobs and provide decent health care to Ugandans. Mr. President we explained to your corrupt and potentially people that we can solve the problem of unemployment in Uganda by creating a Job Creation Fund of approximately Ushs ten trillion shillings. We also explained how we can raise revenue for the said job Creation Fund to ensure sustainability and reduce the impact of redirecting funding from other state priorities.
Mr. President it is admirable to provide medical insurance for all Ugandans because life is precious but the way your people structured the discriminatory National Health Insurance Scheme Bill, workers are always going to rage against it and we might even succeed in having it declared unconstitutional. Why should a worker who is already being exploited by his or her employer and subject to a very high tax and social burden be required to pay more to the national health insurance scheme than rich businessmen and other self employed persons. For example, a lawyer or consultant bringing in five hundred million shillings per year will pay less than a quarter of what a worker earning one million shillings will pay to the national health insurance scheme.
The better alternative is to transform the national health insurance scheme into a job creation enterprise to create jobs for Ugandans. The first step is to eliminate the problematic political considerations that infect Government programmes with inefficiency and corruption. Imagine a quality health insurance scheme backed up by thousands of high class health centres at every parish and subcounty. The advantage is that the infrastructure already exists because there are health centres at almost every subcounty in Uganda. It is a matter of privatising these medical facilities by running them as profit making institutions for the public interest.
Obviously a state sponsored medical insurance scheme is required to ensure that the poor can afford to pay for the quality health care. It will also be helpful if the rich and employed pay premiums into this scheme so that the healthy can subsidize the sick. What we would do differently is to ensure that the premiums are fair to both workers, the poor and the self employed. Unlike the current system we would not charge the workers more than those that are self employed.
After securing the funding from the premiums, the next step is to ensure competition so as to maintain high standards. To ensure competition the health centres will be run by different entities on a commission basis and we would introduce a rating system to ensure that those that provide higher quality medical care can charge higher prices and incentivize better quality medical care. We propose allowing doctors with sufficient assets to serve as collateral to run the medical facilities to ensure efficiency. Managers work more optimally when they have a stake in the business but this does not mean the overall agency should not provide proper oversight.
One thousand health centres could potentially employ ten thousand Ugandans and ten thousand health facilities could employ one hundred thousand workers. By monitizing the health insurance scheme, we shall provide the required quality health care to all Ugandans and create jobs for unemployed Ugandans. It is the perverbial hitting two birds with one stone.