Health

Private Practitioners Decry Over-taxation as Gov’t Demands Affordable Health Care

The private sector has played a significant part in as far as access to health care in Uganda especially at a time when the government health facilities are doing poorly in terms of drug stocks, equipment and adequate staffing.

But while that is the case, many say that accessing treatment in the private clinics and hospitals comes at a very hefty financial cost.

Others have opined that the lucrative business is the reason numerous private health facilities are mushrooming every day especially in Kampala and other urban areas where people can afford the services.

Dr. Ian Clarke, the Director of International Hospital Kampala however says that the increase of these clinics has come at the cost of professional standards and quality in terms of services.

“There’s a mushrooming copycat culture of small clinics in Uganda. But this is compromising medical principles and the accuracy in diagnosis. You can’t be doing unnecessary test and treatment because you want to send a cheque to your client,” Dr. Clarke commented on Thursday during the annual Grand Doctors Conference.

 Dr. Ian Clarke, the proprietor of Internet Hospital Kampala (IHK) speaking at the conference

Dr. Ian Clarke, the proprietor of Internet Hospital Kampala (IHK) speaking at the conference

However, proprietors of these private health businesses who got drawn into the debate disagree with the notion that they are over pricing their services. Instead, they blame it on over taxation along with the high investments and operational costs that they incur.

“We pay too many licenses and this has cost implications on the patient since the business owner has to recoup the taxes he pays which is unfair,” Dr. Yiga Matovu, a private practitioner said.

“The prices we charge are in tandem with the services offered because the equipment we use is acquired in US dollars and the exchange rate keeps changing. This will affect the fees we charge,” he added.

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He appealed to government to support private practitioners rather than subject them to many taxes, questioning why he should pay for a medical licence to both the Uganda Medica Council and Kampala Capital City Authority (KCCA).

While government had previously created a Medical Fund to offer special loans for the sector, Dr. Matovu says it did not help entrepreneurs like him since the interest rates later became similar to those by commercial banks.

Another private practitioner, Dr. Fred Bisso who also heads Uganda Medical Association revealed that he spends over Ush18 million annually on his business saying he is “chocking” on taxes.

“We want to plead with government to revise these taxes because eventually this burden is placed on the end consumer,” Dr. Bisso requested the Minister of Health who attended the conference.

On its part, government says that the private health facilities have exploited the loopholes in regulation to charge patients expensively.

Health Minister Dr. Ruth Aceng stated; “Private health facilities were initially not taxed but with the introduction of new tax regime, KCCA is taxing them in Kampala where we have the majority of them. We know it affects them. But we are also aware that the prices they are not regulated and they charge patients in differently.”

Minister of Health Dr. Ruth Aceng
Minister of Health Dr. Ruth Aceng

She said that Parliament needs to work out a mechanism that harmonizes the prices charged.

“Whereas some private facilities wrote to us saying they are going to stop vaccinations due to over taxation, we also know that some of these facilities charge patients for vaccination yet these vaccines are already paid for by government,” the Minister said.

Financing

The Minister revealed that government is in process of developing a health financing strategy to mobilize resources to address the existing gaps. Part of the strategy includes appropriation through the national health insurance scheme, resources from implementing partners but also payments by patients themselves.

“Patients will also have to contribute to this if they are to get quality health services. If somebody wants to have a kidney transplant, why agree to pay for it in India but expect a free service if it was to be done in Uganda yet in both cases, the same resources are used?” Dr. Aceng wondered.

But the private sector too is coming up with initiatives to ease access to affordable financing for businesses like that of Dr. Yoga Matovu so that Ugandans can then afford health care.

Dr. Grace Ssali Kiwanuka the Executive Director of Uganda Healthcare Federation told ChimpReports that through Medical Credit Fund and other partners, private health facilities in Uganda will access low interest credit without collateral.

“One of the biggest challenges in private sector is – most of the facilities are not built to purpose so their structures are not designed for patient flow. Yet when they want to acquire equipment to boost their capacity, commercial banks are not willing to give the loans because they don’t have the securities like a land title,” Dr. Grace Kiwanuka said.

“We are partnering with Medical Credit Fund to offer unsecured financing for capital investment for private health businesses,” she added.

With access to such financing, she says private facilities will have the capacity to become one stop centres and cease to make unnecessary referrals.

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