How HMCAN gave birth to health insurance industry in Nigeria, by Ladele

Amidst allegation of corruption and protracted leadership crisis rocking the National Health Insurance Scheme (NHIS), the regulatory agency for Nigeria’s industry, stakeholders in the sector under the aegis of Health and Managed Care Association of Nigeria (HMCAN), have commended the creation of the body twenty years ago, an event they claimed midwifed the birth of health insurance in the country.

HMCAN is the umbrella body of accredited Health Maintenance Organisations (HMOs).Speaking at a press briefing on the forthcoming twentieth anniversary of HMCAN, the Chairman, Dr. Babatunde Ladele said: “As stakeholders, HMCAN have been well nurtured and shielded from so many attacks to ensure its existence in the past twenty years, especially the experience of the last two years. These attacks include cultural and religious tendencies that disallow some people to believe in insurance. Ironically, medical doctors also do not agree with health insurance. This is because hitherto they enjoyed the system of retainer-ships which is predicated on service for fee system.”

He noted that “with the advent of managed care, the paradigm shifted and promoting health became paramount. Unfortunately, many practicing doctors are still not aligned with the health insurance system, particularly in Nigeria. Providers have also said they do not want HMOs, who they claimed are standing between them and their ‘food’.”

Concerning the impact of HMCAN over the years in deepening health insurance culture in comparison with the extent of acceptance and the level of coverage in the country, Ladele blamed the NHIS Act which does not make it compulsory for the citizens.He expressed hope that “with the bill for amendment of the Act before the Senate, health insurance can become compulsory for all Nigerians. May be when that happens, we can discuss the issue of impact; for now, the industry is evolving and we are fully in it.”

Highlighting the achievements of HMCAN in two decades of its creation, the HMCAN Chairman stressed that “the practice of health insurance could have been forgotten in Nigeria if not for the resilience, focus, industry, and dynamism of the Association. You can imagine what the health insurance industry has been going through in the last one year, including the saga involving the suspended NHIS’ Executive Secretary, who was advocating Zero HMO!”

While commending the intervention of the Commissioner for Health, Lagos State, Dr. Jide Idris, who has openly and ferociously defended the industry, he agreed, “a few HMOs are noncompliant but the job of NHIS is to sanction erring HMOs.”

He pointed out that “HMCAN naturally has the moral weight to advise members but do not have the legal wherewithal to punish. Nevertheless, we have a code of ethics already presented as a suggestion that can be incorporated into operational guidelines. Unfortunately, the regulator is in doubt of HMCAN’s sincerity of purpose thinking that we are planning to usurp their roles.”

He disclosed “HMCAN has opened a channel of discussion with stakeholders including the providers and also constituted a few members into a think-tank mandated to intellectualize all emerging issues and try to proffer solutions to them. Part of the efforts is the establishment of a Health Insurance Institute fully registered with the mandate to train and re-train personnel in the industry.”

In his words, “HMCAN is championing the cause of health insurance in the country in all fronts, including involvement in the politics of the Sector. HMCAN members need to be on the Board or Council of NHIS. What stops our members becoming the Executive Secretary? Certainly, there will be a marked difference when people who have good knowledge of the sector superintend these strategic positions. Such persons will know when to wield the big stick. Setting up HMO should not be a means of making fast money.”