BREAKING THE SILENCE, 2014 Breaking The Silence | Page 41

“...there has to be a
mechanism whereby
people are paying into
the pool, so that at
any given time, the
healthy are paying for
the sick. That is the
only thing that is
sustainable”
Now, the World Health Assembly in
I think 2005 asked member states
to adopt methods of health risk
pooling and health risk sharing to
prevent peo ple from catastrophic
health expenditure.
What does that mean? You have a
gateman who earns maybe N30,000
a month or N360,000 a year. One
night, his son develops an
abdominal pain, his only child, they
rush him to the nearby health
centre, and they say he has
appendicitis. Surgery is N150, 000.
That is at least 40% of his annual
salary is required else the child dies.
This is not a fable or a
confabulation, it is real life story.
How does he pay?
So, that brings us to the issues of
Health funding and what the World
Health Assembly was proposing
was a method whereby people do
not have to pay at the point of
service. It is a contributory scheme,
people call it health insurance or
managed care, whatever you term it.
But, there has to be a mechanism
whereby people are paying into the
pool, so that at any given time, the
healthy are paying for the sick. That
is the only thing that is sustainable,
that will allow us to lift from this
hyper-fragmented state to a more
cohesive health system. People
must learn that they need to pay
towards their own health care for
the evil day that surely cometh to
all man – the day they fall ill.
Currently, what type of insurance
do we have available in Nigeria?
There are two basic schemes
running in Nigeria. There is the
public sector firm driven by the
NHIS which has maybe about 3
million people registered – largely
comprised of Federal civil servants
and their dependants: 1 wife and 4
children up to a maximum of 18
years.
Then, we have the Private scheme
which has been tailor-made. You can
actually more or less ask for what
you want and the plan can be
designed.
The private health insurance scheme
has not fully worked because they
are not mandatory. Some flaws exist
in the NHIS Act number 35 of 1999.
There was no compelling clause in
the Act. There is a clause in that
Act which says that “anyone who
employs ten or more individuals or
any company that employs ten or
more may subscribe to the scheme”,
it was supposed to read “shall
subscribe to the scheme” but some
AMSUL Digest 2014