As part of measures to guarantee efficiency of the Health Insurance Scheme in the country,the Health Management Organisation, (HMOs) wants the Federal government to review the existing Laws of the National Health Insurance Scheme, (NHIS), to a National Health Insurance Commission.
This,the Health Organisation body said,would ensure the NHIS focuses strictly on regulatory function,which would enable it address the concerns and confusion of dual role of a regulator and an operator.
Currently,only about 4% of Nigerians are covered by the Health Insurance Scheme in the country,which industry watchers largely attribute to poor regulatory functions of the regulator of the health insurance scheme in the country.
“What we are clamouring to is to review and revise the law establishing the NHIS into National Health Insurance Commission,which would translate the role of the NHIS to strictly be a regulator of the health insurance scheme.As it is now,NHIS is a regulator and operator,and that is why there is confusion which is really impeding on growth of the scheme.”Lekan Ewenla,the National Publicity Secretary of the Health and Managed Care Association of Nigeria (HMCAN),which is the umbrella body of HMOS told select journalists on Monday in Abuja.
He noted further that the NHIS should focus on its regulatory duty just as other regulatory agencies in the country are doing and growing their own sectors accordingly.
He said,”I don’t see a situation where people walk into the Central Bank to deposit money.I don’t see the Nigeria Communications Commission,NCC erecting mast like the service providers do.Their respective role is that of a regulator.This is what we want the NHIS to focus on”
The Health Management body also also raise concern on the disruption and distortion of the payments by the NHIS,which according to the Scheme is designed to be a pre-paid,as they note that the suspended Executive Secretary prefers post paid pattern,which kills the scheme.
”When he came,because of the poor understanding of the scheme,he changed the scheme from pre-paid to post paid.Health Insurance business globally is pre-paid. There are two risk bearers,the hospital bear the risk at the primary level,and the HMOs also.They are expected to be paid in advance so that with access to that fund,they could procure their medication for the services to be provided”
The mode of his payment disrupts smooth operation of the scheme,and even kills the scheme,while some enrolees might also be rejected by hospitals and this is not good for the scheme,he adds further.
The Health Management body also suggested tot he federal government to also review the mode of appointment of the Executive Secretary of the scheme,while ensuring a competent person pilots the affairs of the scheme.
It would be noted that the National Health Insurance Scheme established under the National Health Insurance Scheme Act,Cap N42,laws of the fedration of Nigeria 2004,which is aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various pre-payment systems.