SINCE it was established in 1999 via Decree (now Act) 35 of the Federal Government of Nigeria, the National Health Insurance Scheme (NHIS) has been tasked with the overall goal of enhancing access to quality and affordable health care for all Nigerians. This scheme eventually saw the light of day 27 years after it was first mooted in 1962 as the Lagos Health Bill.
But 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.
But health insurance in Nigeria remains fraught with a lot of problems. Apart from being operated strictly with the government’s contributions, the NHIS has not ensured that every Nigerian has access to good health care services.
Today, there is little or no protection of individuals or families from the financial hardship of huge medical bills. Many individuals have no faith in the Scheme, while a number of corporate bodies have withdrawn from it. Treatment from accredited hospitals is often questionable.
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.
The nation’s healthcare system deserves urgent reformation. What Nigerians need is a universal healthcare system which will increase coverage, reduce maternal and child mortality, while increasing life expectancy of the generality of the citizenry. We must refocus the policy to ensure it meets its laudable objectives.
It is time to provide the legal framework for a new policy shift in order to help poor Nigerians. This is the era of Universal Health Care. Nigeria must take a cue from the industrialised countries and follow the good examples of successful implementation. The existing national health policy only guarantees consumer protection and access to care for citizens on paper. The NHIS as it is and the Universal Health Coverage are poles apart.
Universal Health Coverage should not only involve massive government investment in the health sector, it also encompasses contributions from individuals and corporate organisations, which should be encouraged to invest generously as part of their responsibility and relevance to the society.
We believe that any social programme that only caters for government sector workers while leaving the mass of Nigerians outside the government payroll cannot suffice.
Let us take another look at the NHIS and make it work.