Medical directors seek enforcement of compulsory health insurance, lament 25% coverage

The Guild of Medical Directors has urged federal and state governments to enforce compulsory health insurance, saying coverage of at least 75 per cent of Nigerians would strengthen healthcare delivery.

The GMD noted that current enrolment of less than 25 per cent leaves millions of Nigerians unable to afford medical care and contributes to preventable deaths.

The medical directors said expanding health insurance, improving trust and public confidence in the scheme and ensuring prompt payment to healthcare providers were necessary to make quality medical services accessible and sustainable.

They also called for increased government support for private hospitals, improved security for health workers and measures to address the rising cost of running medical facilities.

The directors made the call at the Annual General Meeting and Conference of the Guild of Medical Directors in Enugu, with the theme, “The Business of Medicine in the Present Economic and Security Challenges in Nigeria,” and the sub-theme, “Digital Health, Telemedicine, Integrating Electronic Medical Records and AI Tools without Breaking the Bank.”

In his keynote address, the Chief Medical Director of Memfys Hospital for Neurosurgery, Enugu, Emeritus Professor Samuel Ohaegbulam, urged governments to enforce compulsory health insurance through the National Health Insurance Authority, saying the scheme could improve access to medical services if coverage reached at least 75 per cent of the population.

Ohaegbulam lamented that many Nigerians who needed medical attention could not afford treatment because of the country’s economic difficulties and rising healthcare costs.

“People come to the hospital, but they cannot afford to pay the medical bill. At times they will say, ‘ Treat us, we pay later.’ Some pay, but some others cannot. Health insurance is the solution to medical treatment.

“Unless the insurance scheme grows, it will be difficult for us to make headway in Nigeria,” he said.

He questioned why policymakers were reluctant to implement compulsory health insurance despite its potential to prevent deaths caused by inability to pay for treatment.

The neurosurgeon urged doctors and other healthcare professionals to support the implementation of the scheme and called for public sensitisation through traditional and digital media, churches, mosques and town unions.

He said wider awareness of the benefits of health insurance would encourage more Nigerians to enrol and improve access to medical services.

Ohaegbulam also identified insecurity, high electricity costs and the migration of trained medical professionals as challenges affecting healthcare delivery.

He said poor remuneration and the difficult economic environment were contributing to the loss of highly trained specialists to other countries.

“Brain drain is another problem facing medical treatment and medical services in Nigeria. Two surgeons we have trained have left the country. We train them, but once they get the opportunity, they move away. The cost of training surgeons is enormous, but, sadly, we have to lose them to brain drain. Poor salary and bad economy have compounded the problem,” he said.

The outgoing National President of the Guild of Medical Directors, Dr Raymond Kuti, also called for the expansion of health insurance coverage, noting that fewer than 25 per cent of Nigerians had enrolled in the scheme despite more than two decades of its existence.

In his address at the conference, Kuti said most people covered by health insurance were government employees, while many Nigerians working in the informal sector remained outside the scheme.

• Federal High Court begins Christmas vacation December 21
• Health insurance: FG identifies Anambra gains in emergency care
• Adesina urges insurers to publish claims, governance performance

“We need to expand health insurance coverage. For over 22 years, less than 25 per cent of Nigerians have bought into the health insurance. The majority of the people insured are actually government workers. Many Nigerians in informal sectors are yet to get NHIA insurance even though it is compulsory. We need to ask ourselves why. The main issues are trust, transparency and openness. Many Nigerians are not sure of getting value for money if they pay for the insurance,” he said.

Kuti said governments at the federal and state levels should focus on regulating the scheme rather than participating as practitioners.

He called for stronger and impartial regulatory oversight of the NHIA, including the regular public release of monitoring reports by government agencies, to improve confidence in the scheme.

“The government at both state and federal levels should be regulators of the scheme and not practitioners. We need an informed, rigorous and unbiased regulatory oversight of the NHIA, including public release of regular monitoring reports from government agencies. This will give the populace trust in the scheme,” he said.

The outgoing GMD president also called for prompt reimbursement of healthcare providers for services rendered, at rates that reflected the actual cost of delivering care.

He said private hospitals were struggling to provide quality services amid high borrowing costs, electricity tariffs, expensive medical equipment and multiple taxation by the three tiers of government.

“We are expected to give globally acceptable, decent, qualitative medical services, have access to mostly expensive equipment and guarantee suitable working environments in situations where the doctors are thinking of how to run the medical facilities on 30 per cent bank interest rates, poor payment rates by patients, band A PHCN tariff and multiple taxation by the three levels of government – federal, state and local governments,” he said.

He said the challenges informed the conference theme, which examined how medical practice could remain sustainable amid financial constraints and uncertainty over the safety of health workers.

Kuti also called for government financial support for private hospitals, proposing a loan guarantee scheme to help them acquire medical equipment, essential consumables and renewable energy systems.

Under the proposed arrangement, he said the government could provide a direct subsidy of up to 30 per cent of the purchase cost or guarantee the same proportion of a loan, provided the repayment period did not exceed five years.

He said such support would help private hospitals reduce their operating costs and provide more affordable services to patients.

The Enugu State Governor, Peter Mbah, represented by the Commissioner for Health, Professor George Ugwu, said his administration was committed to improving access to healthcare through investments in modern hospital infrastructure, medical equipment and the welfare of health workers.

Ugwu said the state was also working towards increasing the number of health professionals trained annually, with plans to produce about 1,000 doctors and 3,000 nurses every year.

“We are assured that each year, Enugu will generate at least 1,000 doctors and about 3,000 nurses to feed this country and the whole world. We want to tell you that Enugu remains a very big industry in the healthcare space as the years go by,” he said.

The commissioner also disclosed that the state was preparing to introduce a law to ensure that every resident is enrolled in its health insurance scheme.

He said the government had developed a policy aimed at ensuring adequate power supply to households and industries, including through the use of the state’s coal deposits.