NIGERIA’S LONG AWAITED HEALTH INSURANCE SCHEME LAUNCHED

On 6th June 2005, the Nigeria Federal Government officially launched the National Health Insurance Scheme (NHIS), 43 years after the concept was first introduced. To demonstrate its commitment to the scheme, the Obasanjo administration said it has devoted a sum of N26 billion in this year’s budget to the programme.

Speaking at the formal launch of the long-awaited scheme, President Olusegun Obassanjo said, “This additional resource allocation is consistent with the United Nations recommendation for the achievement of the Millennium Development Goals for Health”.

An amount of N4.8 billion has been released, which the Health Minister, Professor Eyitayo Lambo, said is part of N6.1 billion non-refundable grant that the government allocated to kick-start the scheme. The shortfall of N1.3 billion is to be released before the end of this year.

The initial target group will be civil servants and their dependants in the employ of federal, state and local governments, as well as private companies with more than10 employees. Civil servants are expected to register with participating hospitals nationwide.The executive secretary of NHIS Dr. Mohammed Mustahpa Lecky explained that the participating hospitals are paid from contributions by the civil servant and his or her employer. Beneficiaries’ will contribute 5% of their wages, and their employer 10% to the scheme. Payment to participating hospitals could be by one of the following methods-capitation, which is a pre-paid payment system whereby the healthcare provider is paid in advance by the NHIS on behalf of the service beneficiary; fee for service payment plan, which is mainly for referred cases to non-participation hospitals; per diem, which simply means payment for services on a day-to-day basis in accordance with the degree of services rendered.

Highlighting the benefits of the scheme, Dr. Lecky said, “The general concept is that when Health Maintenance Organization (HMOs) are registered, there will be a premium rating. For instance, for civil servants and those in employment, the contribution will be 15% of their basic salary. For federal civil servants, president Obasanjo has said will pay for two years. The providers: hospitals and primary healthcare centers will be registered across the country. Every individual will choose a provider of their choice, while the beneficiary will have access to healthcare delivery through the provider of his choice”.

“The process now is that the federal government is responsible for the bills of civil servants. A lot of the private sector has a healthcare scheme in one form or another. The idea is to encourage more private sector employers to join the scheme. Government will fund the less privileged. It should also be mentioned that some HMOs, state government and NGOs are undertaking health insurance for various communities as a social responsibility”.

Also speaking on the benefit of the scheme, a medical consultant, Dr Ndi Onuekwusi said, “The concept is designed to wipe out fake drugs because it has an inbuilt system that ensures healthcare providers provide necessary services and treat properly. Prior to the advent of NHIS, public hospitals in Nigeria were bedeviled by the ‘out of stock syndrome’ for prescribed drugs. In addition, prohibitive medical bills in the public and private hospitals have pushed health services beyond the reach of the average Nigerian, with the result that Charlatans and self-professed spiritual healers are cashing in on their swelling patronage to exploit and compound the health problems of hapless citizens”.

Dr Ndi Onuekwusi observed. “The major problem in our crippling health care system is under-funding and management. Of the entire healthcare funding options available” Onuekusi said “NHIS stands out as the most reliable” and effective, if well implemented. In effect, NHIS serves to spread the health financial burden to all members of the population”.

CULLED FROM THE HEALTHCARE JOURNALI
(August2005- November 2005Edition)