AGITATION for an efficient and sustainable health insurance scheme in Nigeria has engaged government at all levels since the promulgation of the NHIS Act. Recently, a stakeholder’s summit for the amendment of the Act took place in Kano, Kano State. Executive Secretary of the NHIS, Dr. Waziri Dogo-Mohammed spoke to Sola Ogundipe on the essence of the summit. Excerpts:
Why a review summit?
Since 2005, the NHIS Act has enjoyed the input and presence of all stakeholders, but this is the last lap more so we have get the buy-in of the legislators. Now we want to do something with it and bring it back to public domain.
In the last four years we have had national summit, now we are doing a zonal summit to get final input from all the groups on financing the scheme, knowing what the benefit packages should be and what disorders are to be covered. Since people must get some subsidies, we want to know where the resources would come from.
Relevance of the Act
The sole purpose of the Act is to ensure that the NHIS covers all Nigerians. What we are interested in is for the Act to cover every Nigerian as much as possible and also for government to take responsibility for those who cannot contribute.
I know this Act went before the Ministry of Health and the Ministry of Justice. It was to go to the Federal Executive Council, but there was a new Board that called it back because the members wanted to see it. This has always been the problem and one of the reasons why it has taken so long.
In the last six years, we have had so many summits and have always carried the stakeholders along. Bringing it to this level is not the end because there will be deliberation on the issues to bring it to public hearing again. There will be more opportunities but we are giving the stakeholders something on where to start. We do expect there would be some input that will affect what we have now, but we cannot get everybody at the same time.
The NHIS started with the formal sector programme which is to cover workers in government and the organised private sector. Knowing that not all Nigerians are employed, we have developed programmes such as the community health insurance along with voluntary contributors.
This is part of community insurance and addresses self-employed individuals. We have tested this and it is working. We plan to take it to about 50 sites per geo-political zone. An inventory has been done by consultants into the nooks and crannies using rated parameters we developed to select potential beneficiaries.
Now we are doing a verification to interact through advocacy. We want to identify with the beneficiaries on their requirements, for instance, if they have an accessible hospital.
Now there is a programme for students in tertiary institutions to be launched early next year. The HMOs are already doing pilot studies on that. Under this some students who are above 18 and not gainfully employed are covered.
Same thing goes for retirees. We are aware the PENCOM Act did not accommodate the health component of retirement. When people retire, they get older and develop diseases such as diabetes, hypertension, but now there is a retiree programme in place.
Throughout life, armed forces personnel are under 100 percent coverage, and even if they retire, will continue to get coverage
A programme that we want to be recognised in this Act is for the vulnerable tagged “safety net”. It is for Nigerians who are indigent, physically challenged or incarcerated as a result of which they cannot afford care.
But there must be a pool of fund to give this group of people coverage. Already we have thought of a National Health Bill that impacts some money to be utilised for this purpose. That is innovative.
Mobile phone tariff
More innovative is the one kobo per second from the airtime. In Nigeria today there are about 80 million phone lines, What we are looking at is to capture one kobo per second in one minute. If somebody talks for one minute, 60 kobo goes into the pool.
In one day we would be able to realise N6.00 per line. For 80 million callers that equals N480 million per day. In 30 days, that would be N14.4 billion and in 12 months, N172.8 billion. From this kind of resource, we can take care of the vulnerable groups.