June 22, 2017

Health insurance: FG calls for scrapping of HMOs

By Emma Ovuakporie & Levinus Nwabughiogu
ABUJA —The Federal Ministry of Health said, yesterday, that the continued existence of Health Management Organisations, HMOs, in the operation of the National Health Insurance Scheme, NHIS, was no longer necessary, following the mismanagement of funds paid to them for effective health delivery in Nigeria.

The ministry said the HMOs had recorded abysmal failure in the health coverage of Nigerians which has resulted in many avoidable deaths.

Minister of Health, Professor Isaac Adewole, made the case at the beginning of a two-day investigative hearing into the “Compliance rate of the Health Management Organisations, HMOs, to the NHIS contributions and utilisation of funds by health care providers and inhumane treatment of enrollees,” organised by House of Representatives Committee on Health Care Services, in Abuja.

Adewole, who was represented by Director of Hospital Services in the Ministry, Mr. L H Balami, hailed the House Committee for the investigative hearing, saying it was important to evaluate the activities of HMOs in Nigeria.

He said the exercise would enable members of the committee and, indeed, Nigerians the opportunity to assess the performance of the HMOs, with a view to determining their continued existence.

According to the minister, whopping N351 billion had been expended on the organizations so far without commensurate result.

Similarly, Executive Secretary of the NHIS, Professor Yusuf Usman, while making his presentation at the hearing, expressed happiness that a day for reckoning for the HMOs had eventually come, saying: “For 12 years, the HMOs have never been called to account for their misdeeds.”

Alleging sabotage, the NHIS executive secretary, however, vowed to inject sanity into the system and take suspected culprits to the anti-graft agencies.

He said: “More than 70 new born babies and over a 100 women die daily from avoidable mortality, even though they are on the scheme.

“Millions die across the states and there seemed not to be time to fight these anomalies until now.

“When I came to the agency, I saw the potential and I felt the NHIS should perform its duties of helping vulnerable Nigerians to access quality health care.

“The number of Nigerians covered by the NHIS after 12 years are 1.5 percent of the population. Countries like Kenya and Rwanda have achieved better health care delivery without HMOs and health care financing in Nigeria is nothing but a huge fraud.

“I know all these things because I signed the cheques and nobody has been brought to book in the last 12 years. If you want to hear the truth, hear it from me today, because my way of making the scheme work is to hold the HMOs accountable.

“We are told that they are powerful and untouchable because they are owned by some powerful Nigerians, but I have news for you that I’m here to rock the boat. We must sink this boat of corruption that has killed the health care sector of our country.

“They have never been brought to account for the 12 years. The number covered 1.5 percent of Nigerians. You can quiote me anywhere because I sign the cheques.

“Health care financing in Nigeria is nothing but fraud. This is the truth. You want to hear the truth, hear it from me. Nobody has done this over the last 12 years.

“In 12 years, we covered only 1 percent of Nigerians. They have been padding with complicity. They have formed themselves into a cartel.

“You will be Mr. Magu’s guest. My NHIS will be a fighting NHIS. This NHIS will fight for the enrolees.”

Usman urged the committee to do a thorough job of ascertaining the number of Nigerians who had been deprived access to quality health care in the country.

“Honourable members, these people are your constituents, and these guys operating the HMOs are owing them huge money. The NHIS is supposed to enhance the standard of health care delivery and crash the cost of health care in Nigeria, but covering just 1.5 percent of Nigerians  in 12 years, have we achieved the objective?

“Now, I went round and demanded that HMOs pay back monies collected without service delivered, or I delist them, and as I speak to you right now, over 95% of the debt has been recouped by the NHIS, and as we speak, there are no HMOs in Nigeria.

“And we are going to re- accredit all the HMOs in July and when you apply to manage a hospital, I must get a letter of non- indebtedness from the chief medical director of that hospital before you are hired.

“We gave them N37billion just for administrative fees, patients go to the hospitals and are treated like lepers because the HMOs have not paid the providers. I had to stop it, and they took me to court, EFCC and ICPC, saying that I must be made to reverse back to status quo. What should be the status quo, when you hold on to administrative fees and capitation”? He asked rhetorically.’’

Declaring the hearing open, speaker of the House of Repreentatives, Yakubu Dogara, who was represented by the deputy minority leader, Chukwuka Wilfred Onyema, said the exercise was necessitated by the concerns of Nigerians who bemoaned the poor health services under the scheme in the Nigeria.

Giving their separate remarks, the Chairman, Senate Committee on Primary Health and Communicable Diseases, Mao Ohuabunwa and the Niger State Commissioner of Health, Niger State rep 36 Commissioners declared their support to the committee.