If media reports on this unfolding episode are to be believed, the members of the House of Representatives were led into describing the NHIS as “a huge waste of resources” which has been “haphazardly implemented”. The man behind the motion leading to the probe, Razaq Bello Osagie, referred to myriad of complaints about the scheme adding that the scheme had excluded most Nigerians as only civil servants and a small segment of the private sector enjoyed its benefits. Among other charges, the lawmaker stated that “the scheme is supposed to be a platform for affordable and efficient health-care for rural dwellers.”

The most revealing remark by Hon. Osagie is his observation that “six years into the scheme, very little is known about it. It is this self-confessed ignorance that must have led him into making all his other untenable and misleading comments and, by extension, it is this ignorance that also led his otherwise honourable colleagues into passing his motion for probe of NHIS. As a para-medic with better insight into the workings of the NHIS derived from keen interest and participation in the scheme at a stage, I feel duty bound to correct some of these misconceptions. I am not expecting them to drop their probe and I am even hopeful that the probe will eventually enlighten the members on the need to approach their onerous national duties from a position of knowledge at all times.

It should be helpful to understand that the NHIS was never meant to be a platform for affordable health care to rural dwellers. And if it is only civil servants and a small segment of the private sector that enjoy its benefits this is not the responsibility of the NHIS. In fact the NHIS is not an implementing agency but a regulatory body like the NCC or the CBN which has enabling law and operational guidelines. It is Health Maintenance Organizations that implement the health insurance scheme but they too can only provide services they are paid for. The important issue is that all insurance schemes including the NHIS are voluntary and contributory on account of the huge cost implications both for government and even the individual prospective beneficiary. The original plan was to bring some relief to the Nigerian masses by paying their health bills but when the figures started adding up, there was no hesitation in deciding to try it out first with the federal civil servants and even they would have to contribute to the scheme. With workers ever complaining of poor pay you cannot enforce their participation in health insurance if this means deducting 5% of their salaries, so it had to be voluntary.

If Mr. Bello-Osagie really wants rural dwellers or all Nigerians to be covered by the health insurance scheme he should start by mobilizing his colleagues to pass a law for health to be constitutionally guaranteed and the required funding to be adequately provided as Brazil has pioneered. He should also know that efforts by NHIS backed by the MDGs Office to provide health cover just for pregnant women and children in a mere 12 selected states barely took off before it succumbed to the usual problems of lack of political will among the state authorities to pay their counterpart funds and there was no provision for it in the 2010 budget.

The lawmaker would do well also to mobilize for a speedier passage of the NHIS Amendment Bill which has been lingering in the chambers since 2005 so that its provisions shall be mandatory and some of the identified constraints of providing health insurance can be removed. The NHIS has also been reportedly making efforts to creatively introduce the scheme to more segments of our society with its community health insurance, voluntary contributors health insurance, the tertiary institutions students health insurance, the organized private sector health insurance and the retirees health insurance among others. But the bottom line is that it is not mandatory and beneficiaries have to contribute.

Contrary to the view of the House, the NHIS cannot be described as a waste of resources because even with its inherent limitations, the scheme is well-received wherever it is operational especially by civil servants who have government back-up to benefit. Who wouldn’t want to have health insurance in a country where a simple appendix operation costs more than the minimum wage and where pensioners die in penury? Members of the House could make a better contribution to the success of NHIS if they first took the trouble of knowing the basic facts before looking for bad drivers.

Douglas is a health worker in Calabar