Universal health care impossible without insurance

Universal health coverage (UHC) has dominated health coverage as countries mark World Health Day, but family doctors in Nigeria say attaining UHC may not be possible without health insurance that covers all Nigerians. The National Health Insurance Scheme was meant to help Nigerians reduce out-of-pocket spending at point of care. Nearly two decades since its […]

Universal health coverage (UHC) has dominated health coverage as countries mark World Health Day, but family doctors in Nigeria say attaining UHC may not be possible without health insurance that covers all Nigerians.

The National Health Insurance Scheme was meant to help Nigerians reduce out-of-pocket spending at point of care. Nearly two decades since its start, it has only covered less than 5% of Nigerians. Much of its coverage is for formal sector workers.

And other coverage schemes besides that for formal sector workers are less talked about.

“The federal government doesn’t have political will,” says Dr Frank Odafen, president of the Association of General Private Medical Practitioners of Nigeria, AGPMPN.

“We are combat-ready to collaborate and cooperate with the federal government. When their political will is externalized, we will key in and ensure we take health to our patients in their environment but only the government can provide the enabling environment.

Speaking after a press conference to mark World Health Day, he tells Daily Trust, “What we are saying to government is: we the foot soldiers are ready but we are waiting for you to blow the whistle and we will take off.”

Nigeria is estimated to have 20,000 general practitioners and 3,000 family doctors, who work in family medicine hospital units—seeing patients for a bit of all condition treatment and prevention before specialist consultants enter the picture.

“These people treat right across the different needs we have in our lifetime. If they [prevent and treat at early onset stages at primary care level], then hospital specialists can do their job,” says Dr Amanda Howe, president of the World Organisation of Family Doctors (WONCA).

Getting it right is where universal health care, insurance and primary health care connect.

“Every government has to find fiscal space, more money, to create the opportunity to run the health system in an effective way. It could be some government money, some type of insurance, maybe employer insurance, and taxation,” says Howe.

“The more these streams of funds are held together to deliver the same package of care that works for everybody, the more you can govern it, wherever it is—same quality, same kind of offer. And universal health care—you have to be sure what the country means by that.”