There seems to be an upsurge in what is gradually becoming a social problem, going by the several reports of Nigerian hospitals holding patients hostage for their inability to settle treatment bills. This trend, which has been observed in both public and private hospitals, has elicited great concern among health watchers and stakeholders.
This continued practice of keeping patients is not only a violation of national and statutory global human rights instruments; it is a serious embarrassment and international shame. While it may not be that easy to pinpoint to the exact degree of the problem, there are ample reasons to believe that it is now assuming a more frightening proportion. A cursory look at the ‘imprisoned’ patients shows that they are mostly the poor, the very sick, abandoned and neglected members of the society, cutting across all ages and gender.
They are often times jobless and without any known means of survival. That is why the government should be alive to its constitutional responsibility by having a virile social security, to take care of the sick that cannot pay their hospital bills, the unemployed, the old people, the physically-challenged, homeless and abandoned children, among others.
Certainly, there is the need for hospitals to shield themselves against the encumbrances of unproductive debts, holding people in captivity because they are incapable of footing their bills is rather illegal since they have not committed any known criminal offence.
In a country where only the wealthy can afford access to quality healthcare, the operation of a health insurance scheme would have readily be the most logical way to bridge this gap between the rich and the poor, but this has not been the case with our National Health Insurance Scheme that is virtually in disarray. The inability to adequately provide a good social health insurance in the country can be traced, among other reasons to the poor budgetary allocations to the NHIS and the non-passage of the Health Bill by the National Assembly. The health insurance package, as obtainable in other climes like the United Kingdom, is primarily funded through the general taxation system.
Ordinarily, patients given medical treatment should realize that when they access medical treatment in any hospital, they are more or less into a contractual agreement, whether written or unwritten and as such, each party should legally fulfill its own part of the deal, meaning that there should be the provision that will clearly state the conditions or terms on which the service is being rendered. While it is appreciated that some patients are truly indigent and unable to offset their hospital bills, it is just fair that the interest of the hospitals should also be protected. Otherwise, they will soon run out of resources to effectively run the health institutions. Hence, individuals owe themselves the duty of paying for health care services the same way they pay for other goods and services.
That was why Dr Osahon Enabulele, President of the Nigeria Medical Association insisted that this practice of detaining patients is not unethical. “This has nothing to do with ethical conduct, if anything all, the bridge of ethics would have come into place if a patient came into the facility and was not attended to, especially if it was an emergency. This is certainly ethical bridge; the first responsibility is to save life. It does not bother so much on ethical issues. What I expect the professional to do as a way of sorting out issues like this is to go the extra mile to inform local authorities or the state government where the patients come from and put the case before them or even religious bodies and expect them to come to his aid”, he stated.
To worsen matters, many wealthy Nigerians and political office holders are addicted to travelling to the United States of America, Russia, Germany, Britain, India, South Africa and other foreign countries annually on medical trips, spending an average of between $20,000 and $50,000 per trip. This lust for overseas medicare is a manifestation of the fallout of the poor state of the nation’s health system.
Hence, this should no longer be allowed to continue if we are serious about turning things around. Or, what stops the country from serving as a reference point in medical tourism? Last year alone, India was said to have earned over $250 million from fellow Nigerians that besieged the country, seeking better medical care, as its total projected earnings from medical tourism is said to hover between $1 billion and $2 billion.
Therefore, government should be more committed to addressing this decadence by discouraging public officials and political appointees from seeking medical treatment abroad. This could be very helpful and in view of the realities of our time, hospitals should be re-branded to vigorously have functional and sustainable social responsibility packages and other initiatives, which can be worked-out in the settlement of bills of indigent patients.
That is where the role of non-governmental organizations, philanthropists and corporate organizations come in. They should be encouraged to do more for humanity. The NHIS should be repackaged to achieve better results while the passage of the National Health Bill should be expedited.
Kupoluyi wrote from the Federal University of Agriculture, Abeokuta
