Wellness Care Reform: an Chance for Insurance policies Market Participation in Sierra Leone’s Professional medical Care Process

The socialized method of health care shipping and delivery and financing, a relic of the British colonial period, still practiced in Sierra Leone has manifestly failed and any efforts at resuscitating it with no implementation of significant structural and systemic reform will only provide to lengthen the inevitable.

All over the environment, whole point out manage and administration of industries, solutions, marketplaces and the indicates of generation are gradually turning into a relic of the previous. This model as practiced in the Sierra Leone health care method has empirically been established to have served only to stifle innovation, progress, efficiency and high-quality output with a resultant decrease in over-all dwelling and health care expectations of the citizenry. The existing point out of the hospitals and health centers manifestly highlights the systemic challenges endemic in the overall govt owned, managed, financed and operated health care method.

The continued operation of these kinds of a decadent and dilapidated shipping and delivery and financing method, lacking in even the essentials of a fashionable health care infrastructure proceeds relegating Sierra Leone to the very base of the human enhancement index.

The transformation hence of the clinical health care shipping and delivery and financing system into a private insurance or a countrywide insurance based method gives options not only for insurers to acquire industry-based clinical insurance options and insurance policies but also serves to effectuate the Ministry of Wellness & Sanitation’s sought after plan ambitions, as espoused in the 2002 Nationwide Wellness Policy Paper.

Both equally plan and regulatory officials, health care suppliers, the insurance sector and other stakeholders have to be engaged to effectuate implementation of elementary systemic reforms if the state is to avert an even higher disaster.


Under the proposed privatization strategy, the Ministry of Wellness & Sanitation will be reworked from possession and administration of hospitals, clinics, and employer of past resort for all medical professionals, nurses and ancillary health care suppliers into a health company with only plan and regulatory capabilities.

The objective will be for the health company to provide as a plan and regulatory watch doggy mandated with making certain that suitable and high-quality clinical care is furnished at the various private hospitals, clinics and pharmacies that will inevitably be founded with the crack-up of the existing govt owned amenities.

With the crack-up and subsequent purchase or leases of these hospitals, clinics, health centers and other amenities, investors and business owners in an energy to comprehend greatest returns on investments, will economically be compelled to improve high-quality and typical of care, introduce point out of the artwork devices and systems and engender a kind of industry forces competitors which will inure only to the betterment of health people in the state.

A much wanted infusion of capital into the health care sector by these kinds of a privatization strategy will clearly spur extra financial actions in ancillary industries, as the dynamic forces of privatization and industry system forces of need and supply will make sure competitors for the health care pie.

Divestiture of Government Ownership:

The dismantling of the existing mammoth and very inefficient govt owned health care shipping and delivery and financing entity have to from a community plan standpoint be built and restructured to make sure governmental possession and administration divestiture from hospitals and other health care amenities.

Less than these kinds of a scenario the government’s existing massive but woefully mismanaged capital outlay for health solutions will be considerably diminished as inefficiencies of corruption, salaries of suppliers, infrastructure routine maintenance, prices of medicines and diagnostic equipments and other overhead working prices will no for a longer period be recurrent expenses from the nation’s depleting coffers.

A method based fully on a private industry-based countrywide health insurance strategy with private organization and industry competitors at its main appears the most rational reform plan route to make sure a potential audio, efficient and rewarding health care infrastructure.

 Wellness Insurance policies Programs:

The cog which the proposed new method have to revolve all-around is a nationwide community of affordable health insurance options creatively built to make sure a higher pool participation of a majority of the inhabitants. In these kinds of a method health insurance firms and service provider organizations will be founded to industry various health options, with minimum solutions and rates based on industry situations. The duty for monitoring compliance by the various options would fall less than the ambit of each the Ministry of Wellness and Sanitation and the Sierra Leone Insurance policies Fee.

Multi-Payer Process:

A significant plank in this proposed health care shipping and delivery and financing privatization hinges on the enactment of health insurance legislation furnishing for companies to present health care for their employees and dependants as section of a typical positive aspects offer with concomitant tax incentives and governmental subsidies to make sure compliance. With these kinds of legislation the digital free of charge socialized clinical care method, the prices of which have been borne exclusively by the govt will now be based on a multi-payer method in which govt, employees and companies will all take part.

With the method as at the moment structured nevertheless, only the govt has a monetary fascination and stake and when other applications conflict with the financing of health care, politicians have only been too inclined to sacrifice the health of their citizens on he change of their greed and particular aggrandizement.

It is envisaged that health insurance suppliers will introduce concepts and options, these kinds of as Wellness Maintenance Organizations (HMO) and Most well-liked Provider Organizations (PPO), as a result of alliances of health suppliers and insurance firms and promoted to companies, labor unions, governmental ministries and organizations on an once-a-year top quality foundation.

The competitors engendered by these kinds of health organizations for the clinical insurance pie will subsequently end result in aggressive rates, coverage, deductibles, co-payments and rates to make health care prices affordable for all.

The Unemployed:

As unemployment and underemployment are perennial challenges in the Sierra Leonean economic system, the provision of health care positive aspects to this class of the inhabitants have to remain the duty of govt. Professional medical solutions furnished to this class of citizens in a private organization ecosystem have to be reimbursed by the govt on a negotiated and pre-identified cost routine or an insurance system founded in which govt negotiates with suppliers and carriers for the provision of solutions.

As an case in point a fund founded by levying taxes on the private health care suppliers, envisaged to emerge with these kinds of privatization, could be instituted and utilized to pay back for these indigent solutions.

Even further, since the hospitals, clinical clinics and other clinical amenities will be operated as organizations, either for profit or as non-profit organizations, the industry forces of need and supply will certainly make sure that affected individual high-quality care, improvements in diagnostic systems, proficient staff and a normal responsiveness to the needs of the clientele will generate the new market. The lethargic and inefficient ambiance witnessed at most govt hospitals right now with buyer services pretty much non existent would be a philosophy of the previous.

The financial viability of health care organizations will count mostly on the clientele they can bring in and keep making use of the previously mentioned yardstick. Companies of lousy health care options and solutions will inevitably loose business to competitors as each yr contributors will have an chance to improve health insurance options.

Considering that a massive inhabitants of Sierra Leone resides in rural areas, the proposed privatization strategy will make sure the growth of health care amenities into areas at the moment inadequately serviced. This strategy will make sure that clinics and health professionals place up shop in each section of the state in get to tap into the health care solutions offered in these rural areas.

Issues to Insurance policies Businesses:

Building an insurance method and strategy to cater to the needs of the rural inhabitants who typically are self used in farming and mining actions posses a problem to insurers in Sierra Leone, who in the previous have been mostly passive and unimaginative in plan style and design to fulfill the issues and pitfalls confronting the nation’s socio-financial landscape.

Proactive and innovative underwriting of pitfalls have to be enterprise by underwriters, actuaries and marketing professionals to style and design, tailor and price health insurance coverage to fulfill the numerous needs of the insuring community. For case in point, the generation of pools by occupational categories could be a single system by which insured’s, engaged in identical trades could be inspired to sort co-operatives for applications of obtaining health insurance coverage at affordable rates for them selves and dependants. High quality payments as a result of the pooling alongside one another of the co-operatives commodities can be an different payment system for the clinical solutions. Health insurance firms could quite possibly establish subsidiary or ancillary firms entirely for the handling of payments produced by income crops.

The existing method less than which nearly all health professionals and related health care suppliers are used by the govt although at the similar time possessing private techniques would be adjusted with a concomitant govt discounts on salaries, efficiency and other fringe positive aspects. As privatization can take in excess of in the hospitals, medical professionals, nurses and other suppliers will no for a longer period be on the government’s payroll but will somewhat be unbiased contractors with their very own techniques.


While a micro model of the proposed reform has mushroomed in an advertisement hoc method in excess of the years with some massive firms and organizations contracting with individual medical professionals and clinics for the provision of health care to their employees and dependants, the form of systemic and structural overhaul wanted to forestall a whole collapse of the method and lengthen identical solutions to all could only be realized by a complete approach together traces of reforms proposed in this plan paper.