In Uganda, there is one doctor for every 20,000 people making access to affordable health services very difficult.

Although this should be seen as government's failure to provide widely the most basic service to its people, the private sector is using this as an opportunity to invest.

Five out of 24 insurance companies currently operating in the country, offer life and health insurance. There are also other Health Maintenance Organisations that offer health insurance cover to individuals and corporates.

Health insurance entails clients paying a monthly or annual premium towards insurance against sickness, ailment or bodily injury.

"It is about being sure that you will get the treatment you need, when you need it," said Moray Samantha the marketing manager International Air Ambulance (IAA).

Microcare Uganda remains the only health insurance company licensed by the Uganda Insurance Commission. Other providers are AAR Health Services and IAA.

But theirs is not health insurance per se but a rudimentary form of health insurance, which has raised concern among health insurance players about the legitimacy of such institutions. In Kenya, last year, seven HMOs closed due to bankruptcy leaving their clients in tears, which prompted the Kenyan government to require HMOs to operate as insurance service providers.

Currently, however, there is no legal provision in the country to regulate HMOs. But Dr. Ian Clarke, the Chief Executive Officer of International Hospital Kampala, the sole IAA agents in Uganda, said, HMOs are regulated by the Uganda Dental and Medical Practioners Association.

According to Ms Clare Tumwesigye, the Microcare Marketing Manager HMOs only sign "mutual agreements" with their clients, which is a bit risky in case of business failure.

"Since most HMOs are not reinsured they try to cut down internal costs to avoid scenarios where a clients medical bills surpass the HMOs financial capability," Tumwesigye said.

Tumwesigye also criticised the operations of HMOs saying you cannot be a service provider at the same time the insurer

However Samantha said: "We [IAA] do not offer health insurance instead we offer prepaid health schemes to our members."

In cases where the client's medical bills surpass the company's financial capacity, Samantha said, "We are the service providers and not middle-men", as often is the case with insurance companies. In case of hospitalisation at IHK, IAA can handle costs up to $4,000 (Shs7.2 million) after which the client may be required to meet the extra cost.

Since insurance premium is based upon the assessed risk of the sickness occurring, most insurance companies often neglected chronic ailments such as HIV/Aids in health insurance cover. As a result health insurance suffers.

Mr David Mukasa, the Vice President of the Uganda Insurers Association, said: "Insurance companies were not ready to incur financial loss in insuring Aids patients."

Clarke, however, said that health providers like IAA, are far cheaper than insurance companies. "As a medical organisation providing medical services directly to our members, we provide service at a cheaper cost compared to insurance which only act as middlemen," he said.

IAA together with the government offer free anti-retroviral drugs as a no cost addition to its $160 (Shs28,800) per person per year corporate silver policy that benefits a minimum of 10 people. Together with AIG - Uganda, FINCA provides life and disability insurance.

In addition to providing health care financing products for the low-income earners, Microcare also provides health related insurance packages such as group accident policy and workers compensation act.

East African underwriters also offers health insurance. "We send our customers to IHK for treatment," said Mr Joseph Almeida the Life and Pensions Manager, East African Underwriters.

The company also offers corporate life insurance to compensate companies when a client dies in the course of a loan cycle.

______________________________________________

By Godwin Muhwezi-Bonge
Kampala

Copyright © 2006 The Monitor. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).