Hurdles before effective health insurance — AGPMPN

Doctors under the auspices of Association of General and Private Medical Practitioners of Nigeria (AGPMPN), Oyo State chapter has said that for Nigeria to achieve univesral health coverage, disparity in capitation, low payment and otherlapses in its health insurance scheme has to be addresssed

At a dialogue between healthcare providers and Health Maintenance Organisation (HMO) in Nigeria at Ibadan, Dr Olaide Oladipupo stated that despite increased awareness on the scheme in the country, enrollees on the scheme do not have identification cards, and as such impersonation had been a challenge.

He said drug tariff for the scheme had remained low despite increasing cost of medicines.

According to him, tariffs on many surgical procudes were low, and as such impeding access to qualitative healthcare delivery.

While putting the tariff for caesarian operation at N55, 000, he stated that the doctor to do the operation as well as the anaesthetic will charge at least N50, 000 and N20, 000 respectively, thus leaving nothing to the healthcare provider.

Dr Oladipupo highlighted other challenges to include delay in payment  of health bills and arbitrary slashing of bills by HMOs as well as non uniformity of tariff by HMOs.

Dr Diran Olabisi said National Health Insurance Scheme (NHIS) treats different health providers differently, adding that capitation  for providers in major cities was higher than those in less urban cities, although they patronise the same market for drugs and other consumables to provide services.

According to him, the scheme also lacked provision for tissue diagnosis despite its importance for medicolegal issues and patient care.

Dr Adebisi said HMOs need to see healthcare providers as equal partners with them rather than as master to beggars.

Dr Ani, an HMO speaking at the dialogue assured that no HMO will want to undermine other stakeholders in the health insurance scheme, despite the many challenges the scheme is stilled faced with.

He assured that HMOs were already looking at the possibility of adopting a unformed tarrif.

Earlier, Oyo chapter AGPMPN‘s chairman, Dr Dapo Adeniyi said health financing is central to improving health for all in Nigeria, adding that unfavourable changes in Nigeria’s economy is not an excuse for decline in healthcare delivery.

Chairman of the occasion, Dr Babayomi Taiwo said there is no perfect health insurance scheme anywhere in the world

He said that this is only achievable through constant review of the progress on health insurance with the aim to further improve it in the future.