By Lexi Elo
Despite its dream of ensuring Nigerians have access to adequate and affordable healthcare through embracing health insurance, many state governments are yet to adopt the National Health Insurance Scheme, a situation, experts say may jeopardise Nigeria’s quest to meet the 30 percent Universal Health Coverage target for Nigerians by 2015, SundiataPost investigation reveals.
With states such as Kwara, Lagos, Ogun, Ekiti, Niger, Ebonyi having in place health insurance schemes for its citizenry, high out-of-pocket payment for healthcare expenditure dominated non-food items and services bought in 2013, according to Nigerian Bureau of Statistics (NBS), with majority of Nigeria’s 160 million people without health insurance cover.
Dr. Abdulrahman Sambo, former executive secretary, National Health Insurance Scheme (NHIS), revealed that states were not buying in to the health insurance scheme despite advocacy to states on the need to embrace the scheme.
While noting that many states see NHIS as a federal government agency that cannot come and dictate to them how they provide health for its staff or people, Dr. Sambo stated that after the NHIS Act was signed by former President Olusegun Obasanjo, the law became un-implementable as states became totally independent when it comes to health.
[pro_ad_display_adzone id=”10″]
[pro_ad_display_adzone id=”8″]
According to Dr. Sambo “If you go to the states, they will tell you they are providing free health. Are they really providing it? The perception of free health is to have the hospitals, to have the doctors and the equipment. Then you go there to access services. But, now you pay for laboratory services, you go for bed space; do that and that and that. You will see the bill individual is given. And, we see on a daily basis requests for assistance on various issues and yet states will say they are giving free health care, free education.”
“Today, everybody is covered in Ghana. But Nigeria’s NHIS is still at the federal level. Ghana did what Nigeria refused to do, set aside the percentage of Value Added Tax (VAT) and passed to the NHIS. 20 percent of VAT goes to the health insurance agency and provides care for all Ghanaians. We wanted to do that through the Health Bill which is yet to be assented to. A percentage of the consolidated revenue, at least one percent should come to NHIS. How much is that? It is about N50billion.
> He continued “Would that be adequate to give cover to all Nigerians? No. N50billlion per annum to provide cover to 160million people; how much is that per person? May be, N1000 per annual; certainly, it will not be adequate. Yet, it is something. If the Bill has been passed, we would have used it to provide cover to some of the vulnerable groups.”
He pointed out that the current NHIS Act 35 of 1999 by the Federal Government had made it so loose for health to be responsibilities of the three tiers of government.
[pro_ad_display_adzone id=”10″]
[pro_ad_display_adzone id=”8″]
“The federal government is paying its own contribution on behalf of federal employees but the state employees and local government employees are not covered because state government is an employer; local government is an employer. Across the world, there is a compulsion by citizens to embrace health insurance and for those who cannot afford to pay for the insurance. Having this amendment in the constitution spells out what each tier of government –local, state and federal government- is to pay for those who cannot afford such healthcare insurance platform is key. This will go a long way in revolutionizing the healthcare system, Sambo added.
Dr. Femi Thomas, NHIS executive secretary, pointed out that it plans to extend coverage to 40 percent of Nigerians by 2015. As part of strategies for achieving this, Thomas stated that the scheme is already working on the blueprint of a programme of extending effective, affordable and efficient healthcare to all primary school pupils across the country.
