By Sola Ogundipe & Damilola Akingbade
MANY Nigerians are yet to sign up with the National Health Insurance Scheme, NHIS, but Managing Director, Managed Healthcare Services Ltd., a Health Maintenance Organisation, HMO, Dr. Patrick Korie, describes the Scheme as a poverty alleviation measure. Excerpts:

Attitude: Attitude is affecting the uptake of health insurance. Two things contribute to this attitude. When we started the NHIS, we were begging people to please register, we were moving around the Ministries and parastatals begging, but today the attitude has changed. Now they come to our offices to register because they have seen it work and seen people benefit from it.

Patrick Korie

I had a client whose wife delivered her baby in the same hospital with the wife of a friend whose family is covered by health insurance. The wife of the man with insurance paid 10 percent of the cost of drugs, while the wife of the other person paid over N100,000 for the same drugs. He cried out and wanted to know why the huge difference for the same service in the same hospital.

It is health insurance advantage, he was told. That is what the NHIS has done. So you can see the difference between getting registered, and not being registered. Seeing what insurance can do has created knowledge and people come for it.

Poverty connection

Poverty of knowledge and money is an issue. At certain income level, when you tell a man who is struggling to put food on the table to set aside certain money for health insurance, he will tell you that he needs to survive first. So poverty is a problem; poverty of the mind. But then, health insurance is actually meant to address poverty because payment of medical care from out-of-pocket medical expenses have plunged so many families into poverty. Disease has plunged people into poverty but health insurance is meant to address this.

Health insurance creates improvised access to medical care. It reduces or eliminates completely out-of-pocket medical expenses that plunges people into poverty. Insurance reduces the waiting time for seeking healthcare. It encourages sick persons to go and seek healthcare rather than stay at home because they don’t have money until the illness gets worse. At the end, they spend more money. Health insurance eliminates all that, but we need to make our people know that poverty that is making people not to pick up health insurance, is making them poorer, because if there’s any illness, that family plunges deeper into poverty. Some end up selling their property. Insurance eliminates that completely.

Awareness creation: We need to create the awareness. We need to do more, as HMOs. The practitioners of health insurance need to have references so we are calling on those that have enjoyed health insurance to speak up. If you have enjoyed health insurance, speak out.

But if there is no demand there will be no supply. We can break the supply chain, so it is now left for the relevant government agencies to break the supply chain of fake insurance in Nigeria.

Health insurance vs life insurance

Before you get a life insurance, you go for medicals but after picking the medicals, your health can change the following day and if it changes there is nothing to sustain it. If you are to operate a life insurance, you have to show evidence of maintenance of your health. The two should go together.

More importantly, when we look at health insurance, there are people who cannot pay. Who pays for them? That’s why it’s for every Nigerian, and it’s not discriminatory, whether you are rich or poor, so long as you are a Nigerian you must have access to basic health care.

It is a good thing that government is thinking of making provision for the less privileged. That is going to be a buffer, something to augment the existing act to ensure that every Nigerian should have access to insurance.

Stopping out-of-pocket payment: Definitely we are ready. Medical care is funded through taxation. This is already happening in Nigeria. We are ready for it. What we are saying is that people should change the system of payment from out-of-pocket to health insurance, health insurance is cost effective, health insurance ensures that medical care is delivered, health insurance is a poverty alleviation measure because paying out of pocket impoverishes the family. It even impoverishes organizations because they are paying for the medical bill of their staff out-of-pocket instead of having a defined budget for health. Other methods of payment do not give a defined budget for health.