The House of Representatives on Wednesday directed the National Health Insurance Scheme (NHIS) to halt the proposed accreditation of Health Management Organisations (HMOs) pending the conclusion of ongoing investigation into the utilisation of the N351 billion paid without commensurate results.
Dogara gave the directive during the investigate hearing on the compliance rate of HMOs to the NHIS contributions and utilisation of funds by Health care providers and inhumane treatment of enrollees, held at the instance of the House Committee on Healthcare Services, chaired by Chike Okafor.
The Speaker who was represented by Chukwuka Onyema, Deputy Minority Whip, noted that the scheme established in 1999 with overall purpose of securing universal health coverage and access to adequate and afoedable healthcare for all Nigerians has failed.
“The importance of this scheme cannot be overemphasized as no nation can achieve a healthy milestone in the health sector without having such a health finance scheme mandated to check health services and avert what would otherwise be a national health crisis should there be no NHIS.
“Health care in Nigeria is financed by tax revenue, out-of-pocket payments, donor funding, and health insurance (social and community). The NHIS has presented a score card that points to the fact that a lot more needs to be done to reposition the scheme. The scheme and the delivery partners have been subjected to various criticisms, challenges and complaints ranging from untimely payment by healthcare providers from the HMOs to unsatisfactory health services to enrollees.
“Regrettably, there is no mechanism to protect vulnerable families from the catastrophic effects of the exorbitant cost of heath care services in Nigeria. Poor families, who constitute over 67% of our population (well in excess of 100 million Nigerians), cannot afford to pay hospital bills even for treatment of malaria in public health facilities, nor for routine antenatal services,” the Speaker observed.
However in his presentation, Tunde Oladele, who spoke on behalf of Health and Managed Care Association of Nigeria accused NHIS management of warehousing multi billion naira (0.5% of the funds accrued to the HMOs) set aside for establishment of ICT platform since inception of the scheme.
Oladele who frowned at the misgivings against the HMOs, argued that the HMOs managing the private sector health scheme, emphasised the need ro make the NHIS private sector driven.
“All the reports submitted pointed to a private sector driven health insurance programme with primary health care providers as risk bearer at the primary level and health maintenance organisations as the risk bearer at the secondary and tertiary levels.
“Globally, social health insurance programme is prepaid by design with healthcare service properly defined as the risk is cross subsidized with contributions from the healthy and the sick and poor and the rich,” he explained.
According to the documents submitted by Issac Adewole, Minister of Health to the House, 5.25% of monthly salary of Federal Civil Servants and 15% premiums paid by State and Local Governments’ workers have been remitted into the scheme since 2005.
Adewole who was represented by Wapanda Balami, Director, Hospital Services, federal Ministry of Health, urged the House to provide for stiffer sanction against fraudulent operators.
On his part, Boiboi Kaigama, President of Trade Union Congress (TUC) emphasised the need to conduct independent forensic audit of NHIS account.
In his remarks, Mao Ohabunwa, chairman, Senate Committee on Healthcare services lamented that the objectives of setting up the NHIS of universal health coverage in the country has been defeated by poor management.
While applauding the ongoing efforts by the House to reposition the scheme, Ohabunwa emphasised the need to put necessary measures in place to address various challenges facing the scheme.
Speaking earlier, Usman Yusuf, NHIS Executive secretary who alleged that most of the HMOs are operating without licences, emphasised the need for overhaul of the NHIS establishment Act as part of efforts geared to strengthen the healthcare service delivery across Nigeria.
Yusuf who described the activities of HMOs as fraud, unveiled plans to conduct fresh accreditation of the HMOs with the view to weed out the fraudulent ones.
“There is no HMOs in this country. Most of them their accreditation has expired. If by July they don’t renew their accreditation, they will be delisted.
“Biometric will be introduced in the NHIS register in order to reduce fraud in the healthcare sector.
“NHIS will fight for the entrollees and recoup the N351 billion debt. When HMO is blocked more money will come,” Yusuf stated.
On his part, Chike Okafor, chairman, House Committee on Healthcare services, disclosed that over 450 petitions have been so far received by the committee on the failure of the HMOs.
