The Integrated Social Development Centre,(ISODEC) has expressed worry about the current implementation of the National Health Insurance Scheme (NHIS). According to its Director of Programmes, Dr Yakubu Zakaria, nearly a decade after the introduction of the National Health Insurance Programme, out of pockets payments were still the dominant form of financing healthcare of households in Ghana. Speaking at a conference on national debate on tax base financing, a universal healthcare person in Ghana, Dr Zakaria said in Accra yesterday that the situation had continued to deny many poor people from accessing life-saving care. The conference brought together participants from the National Health Insurance Authority, Ministry of Health (MOH) and Ghana Health Service. Although political parties were invited, it was only the Progressives People's Party which attended the conference. The debate was meant to reach consensus on the best financing model that would ensure financial sustainability for the NHIS and universal access to healthcare free at the point of use for all. "The introduction of the NHIS, which was meant to reduce the prevalence of out of pocket payments (OOP) in the health system, has not made significant difference in that respect. Similar to the OOP payment financing, the NHIS imposes insurance premiums as requirement for accessing healthcare, and these create huge financial barriers for poor people to access needed healthcare," Dr Zakaria said. He said the current model of the NHI which involved members making contributory payments was utterly unfair. "The majority of the costs of providing healthcare services to members of the NHI are funded from general tax revenue. Every Ghanaian contributes into the general tax revenue, but it is used to pay for healthcare for mostly high income households who are able to enroll on the NHI scheme," he said. He observed that apart from the fact that coverage of the NHIS was low, the scheme was also in financial stress as the scheme annual expenditures had consistently been above its incomes. According to Dr Zakaria, for Ghana to achieve universal coverage to healthcare, the country should adopt tax based financing to provide predictable and sustainable financing for the NHIS. He also said Ghana must scrap the annual health insurance premiums to ensure universal access to free healthcare.