Low-income families are appealing to the government to come up with a credit facility that allows them to be discharged from a hospital before making a payment.

This is because these families are struggling to pay for healthcare out of pocket despite having access to basic health insurance.

They say they need an arrangement that allows them to make payments in instalments.

While 81 per cent of the population is covered by the community-based health insurance scheme, Mutuelle de Santé, introduced in 2005, it does not cover chronic illness.

As a result, some hospitals are forced to detain some patients after being discharged over failure to pay medical bills.

A mini-survey carried out by Rwanda Today at Muhima and University Teaching Hospital of Kigali (CHUK) found that at least 12 patients were being held inside the hospitals for failure to pay their medical bills.

Beatrice Karinganire, a mother of four, said she was held inside the hospital at Muhima for a whole month because of failing to pay her bills after undergoing a caesarean delivery.

“I had Mutuelles de Santé insurance but because of the difficulties encountered in my delivery the bills rose to Rwf30,000 which my family couldn’t afford,” said Ms Karinganire.

“My husband had to find money to pay the bill before I could be released from the hospital. The time patients spend in the hospital after recovery subjects them to infections,” she said, adding that mothers and babies are sometimes separated and even a death does not guarantee release from the hospital.

“We want the government to hold discussions with the directors of the hospitals so that if a discharged patient fails to pay, they are allowed to sign an agreement about when to pay,” she said.

“It is unfair for a discharged patient to be held inside the hospital for over a month. If the government intervenes, it will be a great step towards saving the lives of many,” she added.
For Francis Ntambara, another patient at CHUK, his medical bill has now accumulated to Rwf3 million and he is required to pay 10 per cent for his Mutuelles de Santé cover.

“This means I have to pay Rwf300,000 cash,” Mr Ntambara said, which is too costly for him.
“If the government could help to pay Mutuelle de Santé for those who do not have the cover and reduce the cost to at least five per cent, it would stop the practice of hospitals holding patients hostage,” he said.

Alex Rurisa, director in charge of Mutuelle de Santé at the Rwanda Social Security Board, said majority of the members of the community health scheme are low-income earners which means many are unable to pay even one per cent of the cost of their medication.

“We promise the public that we are going to seek a solution to this problem. It is a serious issue that requires not only Rwanda Social Security Board, but also the Ministry of Health, Ministry of Local Government and other stake holders in order to resolve it,” he added.

Under the universal medical insurance cover Mutuelle de Santé, the government fully subsidises health contributions for vulnerable citizens, who account for 16 per cent of the country’s population.