Over 67 percent of Nigerians, which amounts to over a hundred million poor families, cannot afford to pay hospital bills for treatment of illnesses such as malaria in public health facilities, Speaker Yakubu Dogara has disclosed.

He added that if Nigeria must achieve its national health objective of providing health for all, a situation where poor and vulnerable families in Nigeria do not have access to basic health services must be addressed by extending the coverage of national health insurance to them.

Dogara spoke on Wednesday while declaring open an investigative hearing to examine the compliance rate of Health Maintenance Organisations to the NHIS contributions and utilisation of funds by the healthcare providers, at the National Assembly. He alleged inhuman treatment of enrollers and also called for creativity and innovation by actors in the health insurance sector to bring in more participants in the scheme.

He said: “Regrettably, there is no mechanism to protect vulnerable families from the catastrophic effects of the exorbitant cost of healthcare services in Nigeria. Poor families, who constitute over 67% of our population, (well in excess of 100 million Nigerians), cannot afford to pay hospital bills even for treatment of malaria in public health facilities, nor for routine ante-natal services.

“If we must achieve desired outcomes and changes, there is a compelling need to expand the coverage levels of NHIS, currently estimated to be about 4-5% of Nigerians, mostly in the formal sector. A scenario where even this abysmally low coverage is attributable to those in paid employment and other types of formal sector creates suspicion of lack of creativity and innovation on the part of key actors in the Health insurance industry in Nigeria, especially HMOs.”

The hearing was organised by the House Committee on Healthcare Services.

Dogara noted that the importance of the National Health Insurance Scheme (NHIS), which was established in 1999 with the overall purpose of securing universal coverage and access to adequate and affordable health care in order to improve the health status of all Nigerians. He said the need for the scheme cannot be overemphasised as no nation can achieve a healthy milestone in the health sector without having such a health finance scheme mandated to check health emergency, reduce out-of-pocket spending for health services and avert what would otherwise be a national health crisis.

Calling for a repositioning of the NHIS, Dogara noted that the delivery partners have been subjected to various criticisms, challenges and complaints ranging from untimely payment by Healthcare Providers by HMOs to unsatisfactory health services to enrollers.

He added that selection of adequate and efficient methods of financing, in addition to organisational delivery structure for health services, is essential if a country is to achieve its national health objective of providing health for all and the way a country finances its health care system is a key determinant of the health of its citizenry.

“Health care in Nigeria is financed by tax revenue, out-of-pocket payments, donor funding, and health insurance (social and community),” the Speaker said.

He called on relevant stakeholders to make contributions towards achieving the goal of the National Assembly to address the challenges, and proffer ideas towards resolving areas of concern so that drastic changes can be made for a better healthcare delivery system in Nigeria.

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