National health insurance scheme (NHIS): History
The idea of creating a governmental body to address health care concerns in Nigeria had its origins in 1962, but the idea was shot down at the time by government officials. Alhaji Abdusalami Abubaker enacted NHIS into military law on 10th of May, 1999, but the Nigerian public had to wait 40 more years for the NHIS to become official. President Olusegun Obasanjo became the first registered NHIS member when he formally launched the agency in 2006.
National health insurance scheme (NHIS): Recruiting achievements
Though there were some resistance and speculations in the outset, in 2013 98 percent of all Nigerian federal employees and two million additional private sector workers were signed up with NHIS. Also, two million additional Nigerians signed up with NHIS through the Programme for Pregnant Women and Children Under Five.
National health insurance scheme (NHIS): Current Recruiting Challenges
Though the NHIS’s stated goal is to provide universal health care access, sadly the percentage of the Nigerian population with health care coverage remains stuck at around 10 percent. Part of the problem has to do with wording of the NHIS Act itself, which requires only federal government employees and private sector businesses with 10 or more employees to register with NHIS. Unfortunately, the majority of government workers work for state agencies, not federal agencies. Since the law does not apply to them, most don’t opt to join NHIS. Another problem is that in the private sector, many Nigerian companies don’t register their employees with the government to avoid paying taxes. Employees who work under-the-table don’t receive health insurance, so it’s a losing situation for everyone except for the employer.
The main problem, though, boils down to a lack of funding. Less than 2% of Nigeria’s GDP is reinvested into its health care programs. Labor unions have blocked efforts to enact laws that would require employees to contribute to their own health care plan with salary deductions, so there just isn’t much money to go around.
National health insurance scheme (NHIS): The Future
Before any significant improvements can be made, the law needs to change. The more people that join the NHIS, the cheaper it will be for everyone– so more people should be cajoled to join. Also, policyholders should be required to pay at least a small portion towards the total cost of the NHIS. Additionally, the public should be provided with more information about NHIS because as the situation stands today, many people have heard the name NHIS but few really know what it means. Currently, most Nigerians view health insurance as just another monthly expense, but in reality health insurance is an investment that can save lots of money in the event that a health problem suddenly develops. Once public perception begins to change, the dream of universal health insurance in Nigeria will begin to look more like a reality.