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The NSHIF will operate as a single risk pool, with all members entitled to the same benefit package thus avoiding fragmented risk pools.
Active involvement of the population in the running of the NSHIF, along with an Appeals Tribunal, was originally planned, but is no longer viewed as necessary.
Administrative costs and reserves will not be permitted to exceed 8% of total NSHIF expenditures.
These results demonstrate that government contributions can be lower than the Sessional Paper recommendations in the early years of NSHIF implementation.
Initial projections of the sources of finances for the NSHIF assumed that it would be possible to use medical allowances paid to civil servants and teachers, known as payroll harmonisation.
To maximise choice of provision for the insured, it has been proposed that patients may visit one of 11 'high-cost' private hospitals, but with the NSHIF reimbursing only up to the amounts paid for public, mission and other private facilities.
The NSHIF Bill requires an adjustment in the structure of the insurance organisation.
Fraud and Investigation, to check the NSHIF's financial activities, and to report directly to the Board of Trustees and ensure transparency and accountability of the NSHIF.
Controlling, to focus on implementing procedures to check budget allocations within the NSHIF departments.
Marketing, to develop and implement the communications strategy of the NSHIF.
Benefits and Quality, to define: (i) standards of health services for NSHIF members at each level of care; and (ii) the criteria for assessing the quality of health service delivery at individual health facilities.
Stakeholders outside government have expressed their concerns with the NSHIF proposal (Table III), and potential solutions to some of these concerns have since been addressed in the various TMRs.
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