UNLESS the Federal Government (FG) immediately inaugurates the governing council for the embattled National Health Insurance Scheme (NHIS), makes it a full-fledged Commission as well as establish the long awaited ICT Platform, curbing corrupt tendencies among administrators may be far-fetched.
This is the view being canvassed by the Health and Managed Care Association of Nigeria (HMCAN), umbrella body for 59 Health Maintenance Organisations in the country as the body reacts to on-going “tragedy” with the Scheme in recent times.
National Chairman of the body, Dr. Tunde Ladele speaking at a media round table in Lagos noted that long before now, there were ominous signs that there could be corrupt tendencies with running of the Scheme, “especially with the non-existence of a Governing Council as provided by the Law establishing the Scheme thus making it possible for anyone occupying the position of the Executive Secretary (ES) to be a boss not answerable to anyone except to itself”.
According to Ladele who was supported by the body’s Vice Chairman, Dr Peter Oriavwote, Publicity Secretary, Lekan Ewenla and Executive Secretary, Barrister Ngozi Nduka-Uba, the NHIS Act 35 of 1999 is obsolete and needs reviewing as indicated by the 2004 NHIS ammendment Bill which made provision for a Council which is expected to oversee the day-to-day running of the Scheme, function as registering HMOs and Healthcare Providers, provide policy guidelines and administration for the scheme, determine after negotiation, capitation and other payments due to healthcare providers by HMOs among other functions in order to check the excesses of the ES as the sole administrator and sole signatory to the accounts of the Scheme.
“Unfortunately what do we have” asked Ladele. “We are faced with a situation that was not created by Law in which an ES has become the sole authority to determine who is an HMO or Care Provider and even disburses more than what the Law stipulates, simply because of the gaps created by non-existence of a governing council”, said the HMCAN Leader.
“The situation has become an aberation in which even the excesses of some Health Mantainance Organisations (HMOs) could not be punished because there is no collaboration between the Regulator and the HMO Managers”, he lamented.
Ladele urged the Federal Ministry of Health to immediately constitute the Council for the NHIS so as to restore the confidence of enrolees in the embattled Scheme.
Also speaking at the media parley, Publicity Secretary of the Scheme, Ewenla, reeled out the six-point agenda of the group which he noted had been on the burner since 2005 to include a short, medium and long term salvaging mechanisms for revamping the health Insurance Scheme saying, “It’s long overdue that the National Assembly should consider upgrading the Scheme to a full-fledge National Health Insurance Commission that will give room for better regualtions as well as make the Scheme mandatory for all Nigerians to buy into and operate rather than the present voluntary exercise”, said Ewenla.
Ewenla said it is only when every Nigerian regardless of their status can be covered in the Universal Health Insurance that its maximum benefits can be felt by the large population of the country.
“If the Law makes it compulsory for every employer of Labour whether in Public or Private to enrol their employees and government also obeys the Health Act of contributing for those who are not covered by the formal or informal sectors the sum of one percent of the total health budget in the event of emergency, health insurance coverage would have gone a long way to reach several millions of Nigerians”, said Ewenla.
He canvassed that its time government sends a Bill to the Assembly to rejig the insurance coverage of the Scheme to enable retirees benefit from the scheme, ensure the contributions mandated by employees are done to enable coverage of more diseases especially the non-communicable which is increasing by the day.
The HMO body also called on the setting up of the long abandoned ICT Platform which according to it “will enable the NHIS Managers as well as the HMCAN follow and monitor the accountability of all Health Maintenance Organisations fulfil their obligations to the Care Providers as at when due.
They noted that technology has made it simple to regulate a system and monitor same by removing human encumbrances “hence, it is only ideal to embrace online administration of the nation’s health insurance Scheme as soon as possible” said Ewenla.
The body also want all premiums paid by enrolees to be warehoused with a National Health Fund sitted possibly at the Central Bank to avoid undue interference and abuse by insurance administrators.
The HMCAN however welcome the suspension and probe of the NHIS saying, ots time Nigerians know how well their funds are managed by the Regulators.
Dr Ladele enjoined Nigerians not to lose hope in the Scheme “as it is the only means to get universal health coverage to every citizen. It is barbaric and archaic for the country to regress into the former situation where Nigerians were paying Hospital providers mostly for services not rendered under the health retainnership method” said Ladele.