The Military Medical Insurance (MMI) is set to become a specialised organ with the ‘necessary’ autonomy in terms of recruiting and managing its staff and determining the procurement rules for better health service delivery, under new law.
The development is achieved as a result of the law establishing the Organ of Military Medical Insurance, which was voted by the Plenary Sitting of the Chamber of Deputies on November 8.
MP Emmanuel Bugingo, Chairperson of the Chamber of Deputies’ Committee on Foreign Affairs, Cooperation and Security, which analysed the bill, said that the changes that MMI wanted and were covered by the law, include that it seeks to make investments so that its ventures generate profit, which makes the insured members get better and affordable [medical] services.
He said that currently, an MMI member pays 10 per cent of the medical bill for the medicines they get in pharmacies [or health services they are provided], adding that such a rate they pay might be even lowered depending on the profitability of its investments.
"If one wants to make investments, and they go through the processes of [ordinary] public institutions, it can derail their progress. That is why it was required much more flexibility so that it (MMI) becomes an organ that makes swift decisions that makes it achieve its mission,” he said.
MP Jean-Claude Ntezimana wondered whether MMI that has been performing well can’t be open to the public so that all people who want it can subscribe to it, like any other insurance.
Bugingo replied that MMI did not close its door [to some people], all people are allowed to join it, provided that they have met the requirements, indicating that the contribution that the Government pays for the current members is higher compared to other insurance schemes.
While explaining the relevance of the bill to MPs on June 6, Maj Gen. Albert Murasira, the Minister of Defence, said that all Rwandans, including civilians are allowed to join MMI, but they have to meet the contribution threshold, which is where the challenge lies as some cannot afford it.
The minister said that contributions to MMI are currently based on a member’s gross salary, where the staff member contributes 3 per cent, plus a 17.5 per cent subsidy from government – which totals to 20.5 per cent of the gross salary.
Murasira said that since its establishment (in 2005), MMI activities have been consistently growing. Initially, its members were Rwanda Defence Force (RDF) personnel and eligible dependents only.
Currently, in line with the growth of the scheme, members of other security organs and their eligible dependents have been on-boarded.
They include the Rwanda National Police (RNP), National Intelligence and Security Service (NISS), public institutions like Ministry of Defence (MoD), Rwanda Investigation Bureau (RIB), Rwanda Military Hospital (RMH), Armed Forces and Rwanda National Police Shop (AFOS).
Others are the MoD affiliated agencies such as Horizon Ltd, Zigama CSS (Credit and Savings Society), Mediasol (a group of pharmacies affiliated to MMI).
In addition to its mission of managing medical insurance for those beneficiaries, MMI also has the mission of investing funds in order to guarantee the financial stability and sustainability of activities under its responsibilities.
Considering the importance and complexity of MMI business and the increasing pace of its activities, Murasire indicated that MMI needs much more flexibility in terms of decision-making and day-to-day operations management by entrusting its Board of Directors and its Management with the necessary powers to respond more quickly to the institution’s growing operational challenges.
MP Angelique Nyirabazayire asked why in the article about people covered by MMI, there are only military personnel and their families, yet there are other people who are protected by this insurance scheme, but were not listed.
In response, MP Bugingo said that though article six provides that MMI covers medical insurance for Rwanda’s military personnel and their families (dependents), it has a paragraph that provides that an order of the Prime Minister determines other people who are insured by MMI.