Chitika

Thursday 18 December 2014

Ohaegbulam recommends compulsory health insurance for Nigerians

RENOWNED neurosurgeon and former deputy vice chancellor of the University of Nigeria Enugu – Campus, UNEC, Prof. Sam Ohaegbulam, has said that the introduction of compulsory Health Insurance for all Nigerians would guarantee every Nigerian free access to medicare anywhere in the country.

While stressing that this initiative would give a big boost to the nation’s healthcare delivery, Prof. Ohaegbulam, who is the Chairman of Memfys International Hospital for Neurosurgery in Enugu State, suggested that Nigerians should be made to pay graded levy for the National Health Insurance Scheme (NHIS), to which employers of labour and the government could supplement.

Presenting the 2014 Award Winners’ Lecture of the Nigerian National Merit Award at the 7th Annual Forum of the Laureates of the Nigerian National Order of Merit (NNOM), at Merit House, Maitama, Abuja recently, the lecturer explained that for low-income earners, the premium should be capped at affordable pre-determined amount, while high-income earners should pay premium based on percentage of salary.

In the lecture, which topic was “Free Healthcare in Nigeria, a Vision or Delusion,” the erudite scholar, however, noted that the Federal Government should pay a predetermined cash to supplementthe income from premium paid by enrollees.

The neurosurgeon observed that if it was true that Nigerians spend over N450b monthly on recharge cards plus other periodic contributions in communities and churches, then it was possible to mobilise Nigerians to pay for their health insurance without coercion, pointing out that the benefits of a comprehensive health insurance scheme were enormous.

He noted that the NHIS would transform our hospitals as more revenue would become available to purchase and maintain equipment,train and hire top level workforce, promote and fund research, stimulate rapid expansion of health facilities, provide employment and discourage the rush for overseas medical treatment.

According to him “If health insurance is made compulsory, the volume of patient will dramatically increase. Let us consider a health insurance plan of just N6, 000 per person per year (N500 monthly) and if they succeed in enrolling 150million citizens, this will yield N900 billion, and by making the subscription a percentage of income, the funds that would accrue to NHIS would be huge.”

Prof. Ohaegbulam, 2010 winner of Africa’s Distinguished Neurosurgeon Award, stated that hospitals and medical practitioners were unhappy with the current fees prescribed for services by NHIS, even as they argued that the fees were too low to cover the cost of treatment, against the backdrop of inflation in the country.

He continued: “Presumably, the fees must have been based on high turnover, which has not been achieved, it is only when the health insurance is made compulsory that high volumes can be generated, thereby making it possible to achieve a fair financial return for those providing the services.

“After 42 years of planning, and 10 years of practice of NHIS, we have only been able to achieve 4 per cent penetration. This calls for soul searching,” he noted.

While calling for the privatisation of the health sector to improve efficiency as is the case with the railways, and the power sector, Ajaokuta Steel Project, the former deputy vice chancellor of University of Nigeria observed that in Nigeria, the private sector has been more efficient, as an unbiased appraisal of the government owned health facilities, educational institutions and industrial outfits confirm this.

He said for privately-owned health institutions to continue complementing government’s effort in healthcare delivery in the country, federal and state governments must provide a conducive industrial climate for them to thrive, just as he expressed shock that private hospitals were made to pay custom duty on imported medical equipment and consumables, while public hospitals were exempted from such payments.

The neurosurgeon added that the Association of General Medical Practitioners, the Guild of Medical Directors and even the Nigerian Medical Association (NMA), had expressed concern over the unhealthy developments.

“My experience at Memfys Hospital for Neurosurgery, Enugu, illustrates the above complaints vividly. Here is a hospital that came on board in 2002 to provide neurosurgical, CT scan, MRI and EEG services in a region where none existed and has discharged these services at the highest level without interruptions for many years despite several challenges arising from multiple taxation from different government bodies, poor electricity and inadequate infrastructure.

Furthermore, the neurosurgeon said that the same hospital had undertaken postgraduate education for neurosurgeons and other health personnel, thereby assisting the government to improve on the shameful statistics in the sector, even as some federal university and teaching hospitals send their students and trainees to the institutions for training, since the goals of Memfys Hospital were high quality patient care, education/training and research.

With more than 100 Nigerian and expatriate staff and modern library with internet access to other on-line resources, the 14-bed hospital and three-bed modern ICU, with the full compliment of operational facilities, the radiology unit is the pride of the hospital.

A single slice CT scanner, and installed a second digital CT in 2005, to become the first hospital to have two functional CTs, while a mobile Cere Tom 8-slice CT was brought in 2009, and in 2014, a 64-slice CT scanner and MRI services were added as the first in the Eastern part of Nigeria to upgrade the neuroradiology services to a higher level, was moving from strength to strength.

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