A safety net has been created under the newly approved National Health Insurance Act for Nigeria’s most vulnerable group to offset the cost of health care, with special provisions from governments at different levels.
President Mohammadu Buhari’s government seeks to provide coverage for at least 83 million poor Nigerians.
The number of poor Nigerians is projected by the World Bank to hit 95.1 million in 2022.
According to the Nigerian Health Insurance Scheme, physically and mentally challenged persons, prison inmates, convicts awaiting trial, offending minors, children under five, pregnant women and the aged will be covered as a vulnerable group.
A Physically Challenged Persons Social Health Insurance Programme has been designed to provide health care services to those whose physical status cannot engage in any meaningful economic activity.
Also, the Children under Five Social Health Insurance Programme programme will cover the health needs of children under the age of five years across the country, who are considered vulnerable. Children, especially those whose parents are participating in Community-Based Social Health Insurance Programme, will qualify.
The federal, state and local governments, development partners and Civil Society Organisations are expected to make contributions in advance to the Vulnerable Group Fund.
But analysts are sceptical that the government will be able to enforce the new law, having failed to honour the National Health Act, which requires that 15 percent of the national budget is dedicated to the health sector.
For several years, Nigeria has struggled to meet half of that percentage.
Runcie Chidebe, executive director at Project Pink Blue, a non-profit cancer advocacy group, told BusinessDay that the new law “is a promise to take the burden of healthcare off 83 million people”.
But like many others, he is doubtful because the Buhari government would leave in less than a year and would leave the implementation to a new administration that might have new priorities to pursue.
He said: “I’m optimistic that it is possible. The only challenge is that the government in power now is signing this when it is already leaving. The healthcare system in Nigeria is largely in the hands of donor agencies and not the government.
“So signing a law that puts more burden on the government when the government has not even implemented the National Health Act of several years that says 15 percent of the national budget should go to healthcare.”
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The NHIS in 2019, for instance, began to cover some cancer medications, which are used for treatment and have been placed on the essential medicine list.
Some aged people in the vulnerable group also suffer from cancer but the provision does not cover most of the expensive drugs required for treatment. The NHIS does not cover surgery and radiotherapy among others.
Chidebe hopes that the government will widen the vulnerable group to include people who are indigent financially, and others battling terminal diseases or diseases whose treatments are really expensive.
According to Femi Olugbile, 70 percent of things that normally take people to hospital are already covered under the scheme, offsetting the majority of the health costs and would leave a significant impact on the already high out-of-pocket expenditure of Nigerians.
“It now depends on whether the government has the will to enforce it. That’s the big elephant in the room. If they have the muscle to enforce then that will be a major game-changer. Government still has to show willingness and deliberate intent and muscle to enforce it,” he said.
