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Why most Nigerians don’t have access to health insurance

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Mr. Olu Obi-Hassan lives in Bariga, Lagos. He was rushed to a nearby hospital after complaining of severe pains in his abdomen. Olu was diagnosed with a rare disease of the arteries, and veins in the arms and legs. His blood vessels are swollen and over time would become blocked with blood clots. Olu could not access medical care as he was unable to afford the medical bills.

The doctors said if Olu were not treated as soon as possible he would lose his legs and arms. He lost the use of his limbs and presently he is unable to walk. Olu now begs for assistance from passers-by on Oshodi/Isolo Bridge in Lagos.

Olu is one of the estimated over 120 million Nigerians without any form of health insurance and have to pay out-of-pocket. It has also been shown that at least 50 per cent of the 120 million Nigerians that do not have health insurance cannot afford medical services.

The Guardian investigations revealed that most Lagosians have poor knowledge of health insurance and do not know about the National Health Insurance Scheme (NHIS) and how to get registered.

The Guardian reliably gathered that out of 30 people, 27 have heard about health insurance and only seven persons were insured.

When asked the reason for not being insured, one of the respondents who is a caterer known as Mama Lucky said, “it’s a scam.’’ Another respondent a primary school teacher, Mrs. Lawal said, “the protocol is too long.’’ While another respondent, Mr. Goke said, “I don’t have a job to maintain the payment.

The Guardian investigation revealed that a number of people who are small business owners- traders and mechanics- agreed to not knowing about the NHIS including a company staff and a few university students.

NHIS was established in 1999 via Decree (now Act) 35 of the Federal Government of Nigeria, the NHIS has been tasked with the overall goal of enhancing access to quality and affordable health care for all Nigerians. Health insurance is one of the most popular kinds of insurance policy that covers an individual’s risk against incurring medical expenses.

The Guardian investigation revealed that since the NHIS became operational in 2005, individuals like Olu still cannott get proper health care.

A Senior Director for the Health, Nutrition and Population Global Practice at the World Bank, Dr. Tim Evans said, “Universal health coverage is an essential ingredient to end extreme poverty and boost shared prosperity within a generation. Putting people’s health needs ahead of their ability to pay stems poverty and stimulates growth.”

Executive Secretary of NHIS, Mr. Femi Akingbade emphasized the right of every Nigerian citizen across the country to affordable health care of good quality, and timely, where ever they are.

Medical director of Adesola Clinic, Bariga, Lagos, Dr. Bayo Windapo, whose hospital is one of the accredited primary and secondary health providers said, “the number of our citizens involved in the NHIS is still very low. Less than 10 per cent of my patients are insured. The people involved are mainly civil servant, generally people who are in public service, but the scheme is spreading now to involve member of the private community.”

Meanwhile, The Guardian investigation revealed that the difficulty in the economy makes it hard for people like Olu to afford proper medical care and health insurance.

However, private health insurance companies are beginning to understand that not everyone can afford medical cost.

“So these private insurance have created a platform where mechanics, vulcanizers, traders, carpenters and other low income earners can get on board,’’ Windapo said. “So other medical doctors like me, encourage them to seek these insurance company around and join.’’

According to him, other difficulties of the NHIS includes mismanagement of funds some times and change in management “which is not good enough for the stability of an insurance scheme.’’

Medical Director of Prince of Peace Hospital, Shomolu, Lagos, Dr. Erinfolarin Adebayo, said, “health insurance scheme is a good idea, over time it will be very good because the idea of pay out of your pocket is very stressful especially at the time of emergency that you have no money but with this scheme you can work in to any hospital and get your treatment. This means with this scheme everyone can get necessary health treatment when due rather than dying on the street or home.’’

Medical Director for Maxi Eye Clinic, Ikeja, Lagos, Dr. Akinola Muyiwa, said, “the scheme gives patients easier access to medical care. So everyone should join because not everyone will have health issues so the ones that don’t have any illness can use their own benefits to take care of others.’’

According to the General Manager, Medical Services at Clearline Health Management Organisation (HMO), Dr. Fagbohulu Charles, “60 percent of Nigerians are living below poverty line, so even what is in their pocket is very small and that is why most Nigerians’ don’t have the attitude of setting aside money for health. They don’t set aside money for health, if they are not ill at that point is not a priority.’


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