A Historical-Cum-Political Overview of Ghana's National Health Insurance Law

• Published in: African and Asian studies 2008-01, Vol.7 (2-3), p.289-306
• Main Authors: Assensoh, Akwasi, Wahab, Hassan
• Format: Article
• Language: English
• Subjects: Africa; Bills; COLONY; EXCEPTIONALISM; Ghana; Health care; Health insurance; Health policy; Health services; INSTABILITY; INSTITUTIONALISM; Institutions; INSURANCE; Insurance coverage; MATERIALLY-POOR; MATERIALLY-RICH; PARLIAMENT
• ISSN: 1569-2094; 1569-2108
• DOI: 10.1163/156921008X318754

In 2003, the Parliament of Ghana passed the National Health Insurance Scheme (NHIS) bill, which was signed into law by President John A. Kufuor. The law provides health coverage for most illnesses of all residents of Ghana. The fact that this relatively small and materially-poor country in West Africa has been able to enact such a law is, in itself, a great feat because it is probably one of the few, if not the only, African country to have enacted such a law. Additionally, it is also a feat that has eluded a materially-rich nation like the United States of America for a considerable length of time. The purpose of this essay is to explore how Ghana was able to pass the NHIS bill into law. Scholars, who have looked at why several major countries, including the U.S., do not have comprehensive health care programs for their citizens have attributed the failure to several factors, including the distinctive political cultures or what some scholars have called the "exceptionalism" of the countries concerned, the impact of interest groups in the internal politics, and the prevailing political institutions. Consequently, we argue that the passing of Ghana's NHIS into law is largely because of the country's current political institutions, particularly the special provisions incorporated into the Fourth Republican Constitution to strengthen the law-making powers of the head of the executive branch of government, headed by a very strong executive President. [PUBLICATION ABSTRACT]