BeyHealth Quarterly Journal (BHQJ) BHQJ 2018: 001:1 (May 2018) - Page 21

FEATURE ARTICLE In Conclusion words, our tax collection efficiency is only about needs to be a re-enactment of Act Number 35, 10% that of South Africa. Suffice it to say that driven by a shared agreement within the In a market economy where demand is cash- for the foreseeable future, the necessary regulatory and policy communities and with the backed, supply immediately responds with activities of the three tiers of Nigerian involvement of key stakeholders. provision and competition and regulation then government cannot be fully funded by taxation The Pension Reform Act, 2014 has established smooth-out the rough edges. The stakeholders or petroleum revenues or the combination of the effectiveness of a compulsory piece of in the Nigerian health insurance space are both. legislation in achieving compelling results, even optimistic that once the funding requirements in the Nigerian environment. The pension for the demand side of the healthcare equation The Proclamation scheme applies to any and all organisations is met through guaranteed revenue streams How then can healthcare delivery be funded in with 3 (three) or more employees in the private from a well-implemented, coordinated and Nigeria? sector. Behold, by the end of 2016, a total of properly administered National health insurance The health funding scenario in Nigeria and other N6.164 trillion had accumulated in the programme, the supply side will respond with comparable economies led to the passing of Retirement Savings Accounts of the workers state-of-the-art healthcare delivery facilities. Resolution 58.331 at the 58th World Health registered under the scheme. This would never Assembly, urging member states – “to ensure have been possible if the Pension Reform Act that health-financing systems include a method had been made optional. for prepayment of financial contributions for The afore-mentioned NHIS Act 35 of 1999 had health care, with a view to sharing risk among another major flaw in that failed to the population and avoiding catastrophic accommodate Nigeria’s federating units, the 36 health-care expenditure and impoverishment of States and the Federal Capital Territory on individuals as a result of seeking care.” acceptable and equitable terms. The States Professor Eyitayo Lambo, world-renowned health economist and Nigerian Minister of Health in 2003 – 2007, was highly instrumental in convincing the President Olusegun Obasanjo-led Federal Government to kick-start the National Health Insurance Scheme (NHIS). days of the preceding military ... our tax collection efficiency is only about 10% that of South Africa have now picked up the gauntlet! With the encouragement of international agencies such operational. By a stroke of administrative as the IFC, Lagos State passed the Health legerdemain, the Federal Government agreed Scheme Act in May 2015, which made to pay premiums on behalf of all public subscription mandatory for more than 20 servants, and the NHIS sprang to life. million residents of the State, exactly sixteen Alas, that’s where the fairytale ends. years after the NHIS Act Number 35 of 1999. The stated Vision and Mission of the Operational modalities for the Scheme are Organisation as published in the October 2005 being fashioned out, from which a quintupling edition of the Operational Guidelines of the of the size of the existing Nigerian health NHIS, are highlighted in figure 1. insurance industry is anticipated in the near future. Political Will Happily following the example of Lagos State, The absence of a clause which makes health other states such as Abia, Kwara, Delta, Ekiti, insurance mandatory for any component of the Kano, Bauchi, Cross River, Ogun, Enugu, Nigerian many Anambra, Oyo, Ondo, Kano and Ebonyi, have commentators to be the gravest failing of the either passed or are in the process of passing is thought by Decree (now Act) Number 35 of 1999. If any fit-for-purpose health insurance legislation on progress is to be made in that regard, there behalf of their citizenry. Issue 1 | MAY 2018 | to provide financial risk protections and cost-burden sharing for people, against high cost of healthcare, through various to their falling ill. This is in addition to providing regulatory oversight to Health Maintenance Organisations (HMOs) and participating Healthcare Providers. With an enrollee population of about 5 administration but had not been made citizenry healthcare costs through pooling and judicious utilisation of financial resources prepayment programmes/products prior The Scheme had been birthed by decree in the dying NHIS Mission Our mission is to facilitate fair-financing of million people, representing less than 3% of the country’s population, the NHIS can be considered to be well behind schedule regarding access to adequate and affordable healthcare and Universal Health Coverage. NHIS Vision A strong, dynamic and responsive National Health Insurance Scheme that is totally committed to securing universal coverage and access to adequate and affordable healthcare; in order to improve the health status of Nigerians, especially for those participating in the various programmes/products of the Scheme. Fig 1: NHIS Mission & Vision Statements. 21