As out-of- pocket payment for healthcare constituting over 90 percent of private spending and less than 5 percent of Nigerians covered by health insurance (both in public and private sector), this development has left majority of Nigeria’s 160 million people without health insurance cover.
While this has created huge market potentials for Health Maintenance Organisation (HMOs) to design health insurance products to deepen insurance coverage, Hygeia HMO is set to grow its market share in Nigeria’s health insurance shape through product development targeted at the formal sector (corporate organisations).
Fola Laoye, chairman, Hygeia Nigeria HMO Limited said that health insurance has been on the front burner in the media due to the nation’s quest to deepen health insurance coverage by 2015, a situation that is still less than 10 percent.
While out-of-pocket payment for healthcare still dominate the nation’s healthcare system due to misconception and lack of information on health insurance, Laoye explained that health insurance is designed to facilitate fair financing of health care costs through pooling and judicious utilisation of financial risk protection and cost-burden sharing for people, against high cost of health care through prepayment systems.
“Healthcare providers should work with health insurance providers to provide a solid platform that would deepen health insurance cover. This is a way health care providers can help promote the scheme. We must raise the bar of qualitative service delivery.
“It has been Hygeia HMO’s tradition to set the pace in the managed healthcare sector; from being the first HMO to be registered in the country to being consistently rated number 1 by international rating agencies including Agusto & Co. The company believes that this new initiative will once again set Hygeia HMO limited apart from other HMOs as it continues to find new ways to make Nigerians live more life” she disclosed.
Ramesh Kurup, chief executive officer, Hygeia HMO explained that the new health plans being launched was an outcome of market insights and the company’s repositioning plan to deliver more value to its clients of its products and services.
With a market share of 20 percent in Nigeria’s health insurance space, Kurup explained that the health plans address the needs of a cross spectrum of customers in the high end, mid level and basic levels with each plan being differentiated by varying levels of benefits.
According to Kurup, “The varying level of benefits gives clients the option of selecting the plans suited to their particular healthcare needs and/or corporate ambitions. This ensures that everyone can have access to quality and affordable, health care. The new products include Hyprestige plus, HyClassic plus, HyPriority plus and HyEssential plus health plans.”
Kurup noted that the launch of the new health plans could not have come at a better time than a time like this when the Federal government is shifting more focus to managed health care with emphasis on universal Health coverage.
Despite added benefits (ambulance services and surgical interventions) across the entire spectrum of healthcare levels, Kurup added pricing remains affordable.
A peep into Nigeria’s healthcare system reveals that over 70 percent of Nigerians outside formal sector, i.e. most of informal sector and rural communities do not have health insurance. Their inability to take part in risk pooling and solidarity schemes endangers them as they remain unable to access healthcare readily.
Several African governments have called for the expansion of insurance-based healthcare financing, to raise additional revenue to fund the cost of healthcare provision as well as diminish financial barriers to obtaining health care at the time of illness.
With an additional $18 per capita needed to provide necessary subsidies to bring over 70 percent into the risk pool, alongside an appropriate benefit package to address the health related millennium development goals (MDGs) and access to emergency & trauma care, industry experts believe that unlocked demand will necessitate a significant investment in Nigeria’s healthcare delivery system, both public and private, and across various level of healthcare.
Alexander Chiejina
