Universal Health Insurance: CNSS added to INAM as administrator

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Extract from the article: The issue of Universal Health Insurance (UHI) was once again the main topic of the Council of Ministers meeting chaired by the Head of State, Faure Gnassingbé, on Wednesday 11 October 2023. Under the terms of a decree, the Institut National d'Assuran

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The issue of Universal Health Insurance (UHI) was once again the main topic of the Council of Ministers meeting chaired by the Head of State, Faure Gnassingbé, on Wednesday 11 October 2023. Under the terms of a decree, the Institut National d'Assurance Maladie (INAM) and the Caisse Nationale de Sécurité Sociale (CNSS) will form the Organisme de Gestion de l'Assurance Maladie universelle. Six other decrees deal with the various aspects of AMU.

Speeding up the implementation of universal health insurance was the main focus of Wednesday's Council of Ministers meeting, in line with the Head of State's vision for a policy to develop human capital and promote social cohesion and harmony.

Accelerating the process of making universal health insurance operational and extending the scope of insured persons will require a new architecture to be adopted, with an implementation plan that draws not only on the experience of the INAM, but also on that of the CNSS in managing social protection.

Basically, nothing changes. INAM will retain its current role as the universal health insurance management body for public employees and those on civil and military pensions.It will also manage universal health insurance for vulnerable individuals and households. The only change is that the CNSS will manage the AMU for employees and pensioners in the private sector, self-employed workers in the informal and agricultural sectors, and ministers of religion. The adoption of this decree will enable the two AMU management bodies to align their work with the timetable for implementation.

AMU and its contours

A 2nd decree adopted by the Council of Ministers lays down the conditions and procedures for subscribing, joining and registering for the medical assistance scheme. This decree reflects Faure Gnassingbé's desire to guarantee access to essential healthcare for all sections of the Togolese population, taking into account vulnerable people.

The 3rd decree adopted lays down the conditions and procedures for joining and registering with the compulsory health insurance scheme.

A 4th decree lays down the terms and conditions of medical supervision of universal health insurance.A 5th decree sets out the terms and procedures for concluding, suspending and terminating agreements between the managing bodies and health care and service providers.

Similarly, the 6th decree determines the powers, organisation and operation of the managing bodies' appeals committee.Finally, the 7th decree defines the values and nomenclatures of pharmaceutical procedures and products covered by the AMU scheme.The law instituting universal health insurance in the Togolese Republic provides for the establishment of an organisation to manage universal health insurance in Togo. A previous decree entrusted INAM with this task. Established by Law No. 2021-022 of 18 October 2021 instituting universal health insurance in the Togolese Republic, universal health coverage aims to achieve equal access to essential or primary healthcare for all.It also aims to improve the quality of healthcare on the basis of national solidarity.

Elom AKAKPO