The recent release of N15billion to the National Health Insurance Scheme (NHIS) from the Basic Healthcare Provision Fund (BHCPF) by the Federal Government is very heartwarming. Speaking at the official disbursement of N6.5billion, which represents the first tranche of the fund to the 15 states, including the Federal Capital Territory that met the eligibility criteria as at February this year, the Health Minister, Dr. Osagie Ehanire, disclosed that the remaining states would be accommodated as soon as they meet the eligibility criteria because the fund would benefit all Nigerians.
The NHIS, it must be recalled, was one of the reforms introduced into the health sector during the administration of former President Olusegun Obasanjo to provide adequate healthcare to all Nigerians at affordable price. No doubt, the NHIS is an innovative reform in the nation’s health sector.
It has been practised in many developed countries for years. In the USA, for example, where it has been in operation since the 1930s, it has been dogged by many controversies with the jury still out on the need to sustain or abandon it altogether.
But the reasoning behind the NHIS concept can hardly be faulted. Universal and affordable healthcare is one of the means of keeping and sustaining a functional healthcare delivery system. It reflects directly on the productivity and wellbeing of the people and ultimately, the development of a country. Just like any insurance policy, the big idea behind the NHIS is to pool the resources of the employers of labour and the employees together into a big pool that can work for all when they need healthcare services. It is like saving for the rainy day that would surely come.
Unfortunately, just like in most other jurisdictions where a model of the NHIS is in operation, the Nigerian version has been dogged by controversies since its inception in 2003. This has provided a needless distraction from the objectives of the scheme and denied many enrolled on the scheme the intended benefits. In practice, the scheme can be turned to a big racket that benefits mostly the HMOs and others involved, to the detriment of the enrollees of the scheme.
Therefore, we hope that the recent changes at the top of the NHIS and the disbursement of some money to the states, the government is now showing its resolve to do things differently and return the scheme to its objectives. The 15 benefitting states are Edo (N301million), Katsina (N636million), Yobe (N270million), Delta (N394m), Lagos (N672million), Adamawa (N342million), Kano (N948million), Anambra (N338million), Imo (N301million), Kaduna (N552million), Bauchi (N530million), Bayelsa (N116million), Ebonyi (N230million), Oyo (N449million), Plateau (N337million) and FCT (N118million).
The amount may not be much, but the expectation is that if it is used judiciously, it would go a long way to restore confidence in the scheme. For the sustainability of the NHIS, there should be accountability and transparency in its management. This is the only way to make it succeed. We call on the operators of the scheme, including the supervisory Ministry of Health at both the federal and sub-national levels, to ensure that the scheme does not falter.
The scheme should be adequately monitored. All noticeable lapses in the administration of the scheme must be corrected. This is one health scheme that should not be allowed to fail. It is sad that less than 20 per cent of Nigerians are benefitting from the scheme. There is urgent need to increase the number of its participants.
Including more Nigerians in the scheme will guarantee adequate healthcare coverage for the entire country. We urge the remaining 19 states to ensure their inclusion in the scheme. They should work out plans to meet the eligibility criteria so that their citizens can equally benefit from the scheme.