Experts in Nigeria, on Thursday, pinpointed several key reasons for the public’s hesitation to embrace health insurance, with factors like steep registration fees and restricted treatment options at the forefront of their concerns.
According to The PUNCH, these issues were brought to light during a Policy Dialogue on Human Capital Development, hosted in Abuja by the Nigerian Institute of Social and Economic Research in collaboration with the African Economic Research Consortium.
This dialogue comes shortly after the National Health Insurance Authority announced a marked 11 per cent rise in health insurance enrolments nationwide over the past year.
The NHIA’s Director General, Dr. Kelechi Ohiri, pointed out that this increase brings the total number of enrollees on their register to approximately 18.7 million.
During the event, Delivery Manager at the Central Coordination Unit under the Office of the Special Adviser to the President on Policy, Osagie Uyi-Aivinhenyo, voiced concerns about the unaffordable costs of health insurance.
He cautioned that, unless these high expenses are tackled, many Nigerians, especially those with lower incomes, will remain reluctant to register for health insurance.
He explained, “I recently took some individuals in their 40s to register for health insurance with some Health Management Organisations, and I found the rates to be prohibitively expensive. This is likely why many Nigerians, particularly low-income earners, are discouraged and unwilling to participate.”
Uyi-Aivinhenyo further lamented the limited coverage of critical treatments under the current scheme.
“If health insurance cannot even cover critical treatments, it becomes disheartening. Additionally, some patients may avoid it because they know they can’t afford quality care,” he added.
He pointed out that while the Ministry of Health is working to broaden the scope of the health insurance scheme, the government’s 2024 target of enrolling 18 million people remains insufficient.
He also highlighted the disparity in healthcare provisions, with certain groups, such as retired military personnel, receiving superior benefits compared to civil servants and the general public.
“Policies in Nigeria are often not all-inclusive. Even in the health insurance scheme, the coverage provided to the military cannot be compared to what civil servants receive,” he stated. “I’ve seen the benefits available to military personnel and veterans under the insurance scheme, which are far superior to what other Nigerians receive.”
Adding to the discourse, Dr. Noah Olasehinde, a researcher from the University of Ibadan, emphasized the need for the scheme to address various imbalances.
He noted that the preferential treatment extended to certain groups isn’t limited to the military but is also influenced by the discretion of Health Maintenance Organisations.
“There are some privileged MDAs [Ministries, Departments, and Agencies] that benefit significantly and are favoured by the HMOs.They determine whether to move an individual from the public category to the special one. So, it’s not just the military that enjoys such inclusion,” Dr. Olasehinde stated. “It’s systemic and somewhat hidden. This issue must be addressed intentionally.”
Dr. Olasehinde also underscored the importance of focusing on women and children, as women, when empowered, tend to manage household care more effectively.
“Women often take greater responsibility for household care when empowered, unlike men who may be less attentive to details,” he said.
Earlier in the dialogue, NISER Director General, Prof. Antonia Simbine, made a compelling case for increasing funding to expand health insurance enrolment.
She emphasized that expanding coverage is essential to reducing Nigerians’ reliance on out-of-pocket expenses for medical care, which often lead to financial hardship.
Prof. Simbine remarked, “Increased funding and ensuring more Nigerians are enrolled in the health insurance scheme is the only way to save patients from relying heavily on out-of-pocket expenses and other catastrophic health expenditures.”
These discussions signal an urgent call for reform, as experts advocate for a more inclusive and affordable health insurance system that truly serves the needs of all Nigerians.
