The Acting Executive Secretary of the National Health Insurance Scheme, NHIS, Attahiru Ibrahim, has said urged the federal government to help underprivileged Nigerians access the scheme.
The NHIS was set up to ensure financing of health care costs and management for Nigerians through the pooling and judicious use of financial resources from the government and participants (enrollees) to ensure cost burden sharing for patients through pre-payment mechanisms.
“Let us remind all that health insurance is a contributory arrangement whereby only the contributors are expected to benefit from subscribed services. It is only those that contribute that will enjoy the services,” Mr. Ibrahim said at an interactive session with journalists on Monday in Abuja.
The scheme has made it possible for the insured to seek immediate care whenever there is imminent need to see a physician.
Mr. Ibrahim said for vulnerable groups who want to participate, “the government has to come in and provide cover for them.”
“Health insurance is contributory. In this context, we have achieved 100 per cent coverage of all contributors in the formal sector made up of employees and the federal government whose contributions make the bulk of our pool of funds. We are calling other Nigerians in the organised private sector and tertiary institutions through our tertiary institution social health insurance programmes to participate in the scheme,” he added.
The acting NHIS chief also said the scheme has covered over 6 million Nigerians.
“So far, the coverage of the scheme today is over 6 million people cutting across various programmes of the scheme. To be able to extend coverage to other less privileged citizens, the scheme looks up to the government to provide funds through the special funding mechanism because they don’t have the capacity to pay for themselves.
“There is no free coverage in the scheme nonetheless, there is an adage that says, ‘even in Freetown there is no free lunch.’”
He added that the scheme will soon commence accreditation of Health Maintenance Organisations, HMOs.
“We have commenced the process and it is going to last for two months, we are also continuing with accreditation of healthcare facilities.”
While urging the media to support and enlighten Nigerians on the schemes’ activities, Mr. Ibrahim noted that there was a gap between the media and the scheme in the past one year. “We are ready to bridge that gap,” he said.
The House of Representatives had asked the minister to halt the re-accreditation of HMOs, pending the outcome of an ongoing investigation of the scheme by the House.
On why the scheme continued with re-accreditation, Victor Amadi, Head of standard and quality insurance, NHIS, said failure to do so will affect service delivery for participants.
“The enrollees who contribute to the scheme need its services. It will be service failure if we discontinue accreditation for the principal programme managers who are the HMOs. its an ongoing thing and of the 57 HMOs we are going to accredit, their licenses have all lapsed. There is need to re-accredit them and that is what the scheme is doing. The process is ongoing.”
Mr. Amadi urged enrollees to be conversant with what is contained in the benefit packages of the scheme and that they should not make demands outside what is provided.
While urging enrollees to give regular feedback on service delivery, Haijya Anibowolo, Head of Enforcement department said a lot of erring health facilities have been sanctioned and delisted from the scheme.