Senate’s proposed mandatory health insurance for Nigerians

The call by the senate last week for mandatory health insurance for all Nigerians, irrespective of their social status, is a welcome development that would guarantee the overall well being of Nigerians and increase the country’s life expectancy, which currently hovers around 50-55 years. The Chairman, Senate Committee on Heath, Senator Ibrahim Oloriegbe, stated this in Abuja at a public hearing on ‘A bill for an Act to repeal the National Health Insurance Scheme Act 2004 and to enact the National Health Insurance Commission Bill’. Health insurance is optional under the current Act.

Oloriegbe said health insurance must be made mandatory and premium payments be subsidised for the poor. “The uncertainty of disease or illness has made it necessary for the need of insurance and its works on certain fundamental principles – the principle of cross subsidisation and solidarity where the rich supports the poor, the well supports the sick and the “haves” support the “havenots”.  This can only be achieved through making insurance mandatory and subsidisation for those unable to afford insurance premiums,” he said. The lawmaker said the country has made almost no progress in reducing maternal mortality. Quoting figures from the National Bureau of Statistics, he said Nigeria records about 900,000 maternal and child mortalities each year. He, therefore, said the need to reform the country’s healthcare sector has become more expedient.

“The Data from National Demographic Health Survey (NDHS) conducted by the National Bureau of Statistics reveals a grim outlook for the health sector. For instance, about 900,000 children and mothers die each year in Nigeria to the extent that there has been almost no progress in reducing maternal mortality and childhood malnutrition is worsening,” he said.  He disclosed that Nigeria contributes 14 per cent of all maternal deaths globally, second only to India at 17 per cent. “It is not surprising that Nigeria contributes 13 per cent of all under-five deaths globally, again second only to India at 21 per cent. This is not acceptable and we need to begin to reverse this trend. It is now clear that the need for health care reforms is very necessary”.

It is instructive that the senate had in July last year directed the Federal Ministry of Employment to put in place policies that would compel employers of labour to procure health insurance package for their employees. The upper legislative chamber also urged the federal government to increase budgetary allocation to the primary health care in the country and directed the Federal Ministry of Health to ensure that the health insurance scheme is accessible to all Nigerians. It said the policy, which must be embraced by management of the public and private firms and establishments, would improve the well-being of workers.

The resolutions followed the adoption of a motion moved by Oluremi Tinubu (APC, Lagos) during plenary. She described PHCs as grassroots, community based initiative that provides health care services to communities, noting that it was universally accepted that access to health care for all was only possible through prevalence and accessibility of PHCs. She explained that the PHC was adopted in 1988 by the National Health Policy to provide promotive, preventive, curative and rehabilitative services. The lawmaker expressed concerns that a lot of the problems in Nigeria’s health sector could be traced to low performance of the PHC facilities.

She said: “The World Bank Service Delivery Indicators Survey showed that the PHC was hampered by lack of financial resources, infrastructure deficit, insufficiency/lack of drugs, equipment and vaccines, among other encumbrances.” The lawmaker lamented that due to the failure of PHC and the belief that it was for lower-income earners, there had been an influx of patients in Secondary and Tertiary Health Care Facilities in the country.

In their contributions, other lawmakers urged relevant stakeholders in the country to join hands and work towards proper funding of the Primary Health Care, for accessible, affordable and efficient service delivery to Nigerians. President of the Senate, Ahmad Lawan, who presided over the session, stressed the importance of the Primary Health Care to Nigerians, particularly the rural dwellers. He noted that the Eighth National Assembly acknowledged this by setting aside one per cent of the Consolidated Revenue Fund in the national budget to boost the provision of basic primary healthcare services across the country.

Blueprint commends the legislature’s unwavering desire to insure the health of Nigerians of all walks of life, irrespective of social status. We, however, urge the lawmakers to go beyond mere rhetoric and take pragmatic steps by way of a legislation that will make it compelling on government at all levels to implement the mandatory health insurance scheme for the citizenry. A mandatory health insurance law is even more desirable now, considering the rising spate of insecurity and spontaneous outbreaks of incurable terminal ailments, which have worsened the nation’s life expectancy. It is, indeed, a sad commentary that a country of over 200 million people does not have a mandatory insurance scheme for its citizens. This situation must not be allowed to subsists, because, according to an axiom, a healthy nation is a wealthy nation.  

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