Not enough HMOs in Nigeria, says ClearLine

Can you say Nigerians are now embracing health insurance?Well, giving the background of health insurance in Nigeria, the practice has been in the pipeline since 1960 for one reason or the other; it never really took off until the time of late General Abacha who at that time was going to sign it into law […]

Can you say Nigerians are now embracing health insurance?
Well, giving the background of health insurance in Nigeria, the practice has been in the pipeline since 1960 for one reason or the other; it never really took off until the time of late General Abacha who at that time was going to sign it into law but eventually, it was General Abdulsalami who kicked off the initiative which was eventually rolled out by General Olusegun Obasanjo in 2005.
He made it compulsory for federal civil servants and their dependants to be enrolled.  Only a few of us were in the health insurance business prior to that time as far back as 1997. We were not calling it health insurance because the connotations of insurance make people associate it with fraud.
They  had this notion that it is when they want to make claims that those companies will start dodging.  We didn’t call it insurance also because some people ascribed it to calamities asking why they should insure their lives against calamities when God is there for them. So, the word insurance wasn’t there we were calling it managed care,  a vehicle for health financing.
Whether we like it or not, the World Health Organisation (WHO) has been talking of a percentage that has to be set aside for health as part of the universal suffrage. Apart from that, health is one of the basic conditions in the human life circle, when we talk of food, housing, people say they will talk of health first even before food or any other thing. Health is first because whether you think of housing first, food next, health is important.
You know by the time you talk of health, things go with it,  good housing, potable water, energy and so many other things associated with health. Now, immediately Nigerians embraced it, we had a lot of work from WHO and IFC because they are international finance organizations who make sure these things work.
The regulator is there on one hand, the National Health Insurance Scheme (NHIS) which we are the promoter because it is a Public Private Partnership (PPP) initiative and the third leg is the providers, the hospitals and health care centres. So far so good, it can be better.

How will you describe Clearline’s experience as a managed care service provider?
 You see this is the only country where you need to convince people about what is good for them. Somebody said a good leader is someone who leads his people to where they are or where they ought to be, the same thing applies to health insurance. I created a scenario where I said the sobriety that is associated with you when you go to a morgue in terms of the number of people that are dead, their age and in fact the life expectancy in Nigeria, the infant mortality rate, maternal mortality and morbidity, when you take all those things into consideration and then look at the economic problems in the country, creating this sub health financing system irrespective of whether you are poor or rich, you are entitle to health cover is the best thing that has happened to us.
There is a paradigm shift though one can say the number of lives that are covered for now may be insignificant in the sense that the Act itself has made it compulsory.  So if it is compulsory for you to have one health insurance or the other at least to be able to have access it is good and that is part of the reasons why we say social insurance should go in hand with this.
Do you think HMOs in Nigeria are well regulated?
We are pioneers in managed care health services, before government acts we set up a group called Health and Managed Care Association of Nigeria (HMCAN). We were careful not to put insurance there and presently we are praying that all HMOs join the group because entry is free and exit also free. It is not compulsory that you must be a member because we don’t want to be seen as a trade union. But we now have the NHIS.  

Can the health bill address woes in the Nigerian health system?
We have made inputs either as guild of medical directors, or NMA and HMCAN which is for managed care providers.  The beauty of the bill is the social aspect that states that certain amount of money is meant for the NHIS to provide health care for all Nigerians irrespective of their status whether you are working or not everybody must be covered because there will be enough in the pool.
What the health bill is saying is that the government by Act of parliament is meant to make certain commitment to health care delivery. Health insurance as it is now, some people will say is not on the concurrent list and that the states for example can do what they want, when they think of the amount of money they have to set aside for  health programmes. These things are not intangible and politicians look for tangible things.