Opportunities abound for investors looking into the Nigerian health space as the senate is on the verge of passing a Bill for a law making health insurance compulsory for all.
The Bill, known as the National Health Insurance Commission Bill, will repeal the National Health Insurance Scheme (NHIS) Act 2004 which makes it optional for employers with at least five employees to enrol them in one form of health insurance plan of the other.
Industry experts are already lauding the move, saying it would open up opportunities for investors to take advantage in closing Nigeria’s underserved health insurance sector as more and more Nigerians are compelled to enrol.
The experts, who spoke at the BusinessDay Annual Workplace Health and Wellbeing Conference, said the new Bill, when it becomes law, would assist the country to a large extent in achieving the much-sought-after universal health coverage as more Nigerians would be compelled to take up a health insurance cover.
“It is very exciting for us in the industry because for a very long time, we have been advocating a national health insurance regulatory body that is distinct from the National Health Insurance Scheme,” said Adesimbo Ukiri, managing director/chief executive officer, Avon Healthcare Limited.
“One of the provisions for the old Act was that an employer of labour with up to 10 staff may subscribe to a health insurance plan for its workers, but the new bill is making it mandatory, and I think that is very important because we need to have a health insurance pool that will be able to cover all Nigerians and if it is not made mandatory, people would not see reasons to subscribe to it,” Ukiri said in a panel session at the conference themed ‘Establishing Linkages among Health, Productivity, and the Bottom-line’.
Ukiri noted that the bill got several nods by industry stakeholders when engagements were made between operators and the regulators at the floor of the senate, but did not mention any likely date when the bill will be passed.
Achieving a universal health care coverage has been an almost difficult task for Africa’s biggest economy, whose over 200 million citizens still find it hard to access quality health care services.
The NHIS was established in 2005 with the objectives of making health care available to Nigerians at an affordable cost.
Over 14 years down the line, it appears the NHIS is losing grips of its mandate as industry stakeholders noted the scheme has only been able to cover at most 5 percent of the population, with many Nigerians still paying out of their pockets for medical expenses, a retrogressive health care funding mechanism.
On several occasions, executives of the scheme have been fingered in issues bordering on corruption.
“Nigeria’s failing health system is not due to having regulations or having the right ideas, I believe the problem is on the execution and the delivery of the right regulatory ideas,” noted Busola Alofe, CEO, Chattered Institute of Personnel Management (CIPM).
The HMOs seen as private sector players who play a dominant role in the scheme also have a fair share of the problem, with many of the hospitals who are the health care providers blaming the HMOs for not remitting despite collecting money from corporate enrollees of the scheme.
Ukiri noted that many of the problems of non-remittance are due to lack of transparency in the system.
According to her, of the about 70 registered HMOs under the NHIS, only about five are commercially viable and liquid enough to sustainably take on insurance claims as at when due.
She blamed these lapses on lack of quality regulation on the part of the NHIS.
She said as opposed to other regulators like the Central Bank, PENCOM, and NAICOM, the NHIS fails to disclose to the public financial reports of HMOs so that the public can ascertain those that have the capacity to take up financial claims.
“Sanitising the sector will make local players to rise up to international levels in terms of size, financial capacity and other parameters that other international health insurers are measured by,” she said.
“Since we HMOs survive by spreading the risk of health across, we cannot provide health cover for people who are aged even though they need it more. If we do this, we will run bankrupt because at that stage of life, they are exposed to regular sickness and that is not seen as insurance since they are expected to fall sick,” she said.
The experts agreed that the role of the NHIS should be structured as a regulator and not an operator.
JOSEPHINE OKOJIE, ANTHONIA OBOKOH & MICHAEL ANI
