Principal-agent problems in implementation of Ghana’s health insurance scheme

Authors

DOI:

https://doi.org/10.12660/joscmv11n2p59-74

Keywords:

Principal-agent, health service providers, health insurance clients, pharmaceutical supply chain, Tamale Metropolis

Abstract

Principal-agent relationship exists between health service providers and their authority and clients. It asserts that health service providers as ‘imperfect agents’ of the authority and clients will take actions that aim to maximise profits at the expense of authority and clients (principal). The situation is possible when reimbursement is based on fee-for-service or a diagnosis-related groups. It looks at relationships between health service providers as agents and health insurance authority, and clients as principals in areas of provision of health services, supply of drugs, medicines and reimbursement. Results showed the private health service providers prescribed more drugs and medicines for clients towards profit maximisation (agency) than their public counterparts. Also, it was found that the public health service providers continued to provide health services and drugs despite health insurance authority indebtedness to them exhibiting more stewardship towards health insurance authority. It recommends strict regulations in tariffs/vetting claims and prompt reimbursement.

Author Biography

Daniel Dramani Kipo-Sunyehzi, University of Ghana

Legon Centre for International Affairs and Diplomacy

Published

17-11-2018

Issue

Section

03.Logistics and Supply Chain