The creation of the National Council for Universal Coverage (CNCU) by the Head of State has sparked discussions and questions about its ability to ensure optimal health coverage for all. In this article, we will analyze the challenges facing the CNCU and propose solutions to strengthen access to health care in the Democratic Republic of Congo (DRC).
One of the main weaknesses of the CNCU lies in the fact that it does not guarantee free healthcare, but rather a deferred payment system so as not to impoverish households in distress. However, it is important to ask what will be the consideration for this deferred payment. Are the pilot hospitals in danger of going bankrupt in the face of the rigidity of government action? These questions require careful consideration.
To achieve effective universal health coverage, we suggest the creation of a “Health Fund” which could be a major support and guarantee reliable execution of the vision of the Head of State. By taking into account the service providers, taxable persons and their dependents of the existing social security funds (CNSS and CNSSAP), which represent more than 30% of the population, this fund could extend its action to the rest of the population by deducting part of the taxes to enrich its resources.
Indeed, if the DRC already has two social security funds, it is necessary to emphasize that health care constitutes an autonomous branch with undeniable humanitarian characteristics. Health care is essential and is one of the branches of social security recognized throughout the world. However, their support is often limited due to the high cost and complexity of the resources needed to ensure their viability and quality.
To support the vision of the Head of State and gradually achieve this universal health coverage, it would be wise to merge the technical data on providers and beneficiaries, as well as the financial resources of the two existing social security funds (CNSS and CNSSAP) to create an initial database for the future national health fund. This first phase could focus on the coverage of active workers, retirees and their dependents.
In conclusion, to achieve effective universal health coverage in the DRC, it is necessary to rethink the CNCU model and create an autonomous health fund. By combining the resources of existing social security funds and advocating for broader public participation through tax levies, it is possible to ensure equitable and affordable access to health care for all Congolese