OPINION

Nigeria's well-designed health insurance: Achievement still far away
By Odimegwu Onwumere

Odimegwu

Many Nigerians were yet to tap into the enormous advantages of health insurance, said experts. Hence, voices were being raised incessantly in Nigeria suggesting that health insurance should be made available to all Nigerians and not only a handful that can pay.

Those in this clarion call were of the view that healthcare of everybody was sensitive and should be first on the index of things not minding religious affiliation, creed, gender or tribe.

Worried by the gap between the Nigerian masses and the healthcare, the former Chief Medical Director of the Lagos University Teaching Hospital, LUTH, Prof Akin Osibogun, in November this year outlined the need for mandatory health insurance scheme for all Nigerians in his book titled, “My Life, My Medicine: A Chief Medical Director’s Story”.

The professor said that the health insurance would add importance and appeal in balancing payment for personal health services. However, the irony was that governments at all levels were yet to take charge in alleviating certain health goods and services that were supposed to be for public interest. 

Health connoisseurs like Osibogun were worried that there were health issues, problems and diseases which if not managed properly but left for the individual to handle, could widespread. Buttressing his point, it was noted that the model to give access to citizens and protect them from spending much can only be achieved through a workable health insurance scheme.

A call for emergency in the health sector

Checks unveiled that the health insurance, perceivably, was programmed for government sector workers while mass of Nigerians were not meant to have hope in the government payroll.

In order to arrest the challenges facing the health sector, the Federal Government had launched the National Health Insurance Scheme, NHIS, in 2005. But regrettably, experts said that the commission was still lame-ducking.

During its “NMA’s Physicians’ Week” recently, the Nigeria Medical Association (NMA), called on General Muhammadu Buhari to declare emergency in the health sector.

The reason was that there was dearth of well-designed guideline for medical practice in Nigeria, because the Medical and Dental Council of Nigeria, was wrongly dissolved.

The NMA lobbied for the appointment of a Chief Medical Officer of the Federation to superintend and fast-track the urgency needed in the health sector. It also called on the authorities to instantaneously start the discharge of the 2014 National Health Act. It added that there’s need for a vivacious primary healthcare system in the states to enliven immunisation and healthcare.

Pharmacist Abiola Olubunmi Paul-Ozieh who’s the Chief Executive Officer, CEO, of Pharmacy Villa and High Rock Pharmacy and currently, the Chairman of the Association of Community Pharmacists of Nigeria (ACPN), Lagos State and the vice-chairman of Healthcare Providers Association of Nigeria, (HCPAN) Lagos State, told Vanguard Newspapers in an interview in June this year that the NHIS was bewildered with constraints such that the law that guided the NHIS was flawed.

“The enabling law in NHIS stated in section 16 that all Nigerians “may” attach to it. It was not compelling, for it to be compelling you need to put something like “it shall be”. When you make something compulsory, everybody knows that they have a stake in it,” Paul-Ozieh said.

Paul-Ozieh added that her team was looking at that area, “how do we bring in people in such that people no-longer depend on out of pocket expenses when sickness comes, people won’t stay in the house for another one day, two days two weeks before they can access health.”

She was of the belief that the only one way to ensure that NHIS was accessible, affordable and available to Nigerians would be through the health insurance.

It was evocatively effective that the NHIS in total sponsorship by the government had not been able to meet the health needs of Nigerians. Many Nigerians were worried that there was no profound health insurance scheme, as many had no hope in the scheme, to subsidize the mountainous hospital bills that Nigerians incur in the country.  

A source in Vanguard Newspapers reported, “While consumers often accuse healthcare providers of being too profit-conscious, many hospitals complain of non-payment of the bills of patients treated by them. Clients also moan that many diseases are not covered and they are given substandard drugs.”

Scarce achievement upon reformation

Gasping for the breath to rejuvenate the health sector, the health insurance scheme became operational in Nigeria in 2005.

This titular scheme was launched in 1999 via Decree (now Act) 35 of the Federal Government of Nigeria, the National Health Insurance Scheme (NHIS), having been first debated in 1962 as the Lagos Health Bill, before it became operational in 2005.

The editorial of Vanguard Newspapers, October 8 2015, accounted, “Since it became operational in 2005, the scheme has not been on track to meet its primary target of providing universal coverage for all Nigerians by 2015. Its poor implementation has not justified the years of spadework invested before it became a reality.

“For many years now, the state of the health system in Nigeria has been in jeopardy. Even after 55 years of independence, Nigeria still ranks low among the World Health Organisation (WHO) member nations.”

To make the NHIS work

On April 27 2015, the Nigerian National Telecommunications Carrier, Globacom unveiled mobile health insurance product in Abuja, to help boost Nigerians’ access to quality health care.

“The mobile health insurance product was formally unveiled in Abuja on Monday by top Globacom officials and senior officials of the National Health Insurance Scheme (NHIS).

“Nigerians who subscribe to this scheme will be able to use their mobile phones for pre-defined medical treatment for which affordable premiums are remitted through the subscribers’ mobile phones,” reported a source of Globacom.

Investigations revealed that, that innovation was intended to provide a lot of options when it finally widespread.

“There won’t be many excuses like, I can’t go to their office, I don’t know the direction to their office; as people can register with their mobile phones, access the services available, people can choose their healthcare provider, Health Maintenance Organization (HMO), the hospital or clinic, pharmacy, laboratory that they want. These are the options that would be available on the mobile health insurance platform,” reported Paul-Ozieh.

How to get out of the conundrum

Experts at the Vanguard Newspapers opined that the healthcare system in Nigeria deserved urgent reformation to assist poor people. They suggested that the time was ripe for a policy on legal framework, because the era was for Universal Health Care.

They added that the country needed to queue on the formations by industrialised countries and tap into how they set the pace for Utopian execution. They believed that the national health policy on ground only exists on the pages of the newspapers because it does not physically guarantees consumer protection and access to care.

Odimegwu Onwumere writes from Rivers State, Nigeria