Perception of moral hazard in Ghana's health insurance scheme: A study of the Sekondi metropolitan assembly

Abstract

Ever since the implementation of the National Health Insurance Scheme (NHIS) by the government of Ghana in 2003, cost of financing has been increasing from time to time, to the extent that some of the schemes have encountered financial distress. Though subjective reports exist that show high expenditures made on the health insurance schemes by the service provided, it is not clear if such high expenditures can be attributed to the incidence of moral hazards. The study sought to examine healthcare consumer’s perception of moral hazard in Ghana’s NHIS. A household survey was carried out within the Sekondi-Takoradi Metropolitan Assembly in the Western region. Questionnaires were used. Cross-sectional primary quantitative data and probit model was used for this study. The outcome of the study shows that, Ghana’s NHIS is also suffering from moral hazard. The insured tend to utilize the hospital more than their uninsured counterparts. However, the probability that an individual perceives the existence of moral hazard in Ghana’s NHIS’s depends on age, sex, income, health status, insurance status, and out-of-pocket payment. The study recommends that scheme managers should facilitate in marketing and publicizing the scheme within the metropolitan. Also, there is the need to consider the potential to use risk rated premiums in order to reduce moral hazard. However, co-payments could be introduced as an incentive mechanism to steer healthcare demand and it is important to impose them on healthcare services with elastic demands.