Why health insurance must be made compulsory now—Expert

For qualitative healthcare to be available to Nigerians in the face of the current economic challenges, an expert in medicine, Professor Abiodun Ilesanmi has adviced  the Federal Government to make enrolment in the National Health Insurance Scheme compulsory.

Ilesanmi, a former Chief Medical Director, University College Hospitals (UCH), Ibadan spoke at the opening of 2016 Annual General Meeting of the Nigerian Medical Association (NMA), Oyo state Branch.

The expert said that not much progress would be made in the financing of health care and in achieving universal free healthcare until health insurance becomes mandatory.

According to him, “That only four per cent coverage has been achieved so far speaks volume about the lack of seriousness in achieving universal healthcare in Nigeria. Even in universities and other higher institutions owned by government, NHIS enrolment is still laughable.

“One of the reasons for this when you interact with people is that they are lacking confidence in the NHIS.”

The expert, noting that Nigerians must be convinced that health is important as housing, clothing and food, added that the National budget should also provide 15 per cent for health at Federal and State levels in keeping with the Abuja recommendation of 2001 to ensure there is no underfunding.

According to him, “if implemented, the revenue injected into health will increase nearly three-fold which will make a big difference.”

The expert said that fragmented governance and lack of transparency, coupled with a big financing gap, has led to weak infrastructure in service delivery and information systems, an insufficient skilled workforce and a lack of medical products/logistics.

These challenges, he declared, had resulted in a high and growing burden of disease, including a shift of disease profile towards non communicable diseases like hypertension as well as neglect of primary health care and specialised medical care, among others.

As parts of strategies to improve access to qualitative healthcare, Ilesanmi suggested that government should fund some natural payment schemes like the community health insurance and introduction of privatisation into healthcare in select institutions.

Also of importance is to streamline bureaucratic processes that limit access to money to establish health facilities, especially private health facilities.

According to him, “the will to improve healthcare is abundant, but what is in short supply is the financial strength to actualises those lofty plans.”

Ilesanmi also suggested the use of private sector to boost healthcare as well as increased research into traditional medicines /traditional health care and the incorporation of the efficacious ones.

Dr Kayode Obembe, former NMA National president and chairman at the occasion said the meeting was aimed at reflecting on the ever increasing economic challenges in Nigeria given that health is crucial to people’s existence.

Although the National Health Act made some provisions for funding health and as such can support achievement of universal health coverage, Obembe said asking state governments for counterpart funds will make the act unable to achieve this.

Also, the fact that such funds must first pass through the state government’s treasury, he said will prevent getting to the local government where health problems abound the most.

To ensure that Nigeria achieves universal health coverage and Sustainable Development Goals, he suggested that the Federal government should establish a health tax fund.

The monies for the health tax fund, he said, could come from charging phone, cigarette and alcohol users among others.