The country’s health insurance sector is set for reforms, as plans are being made by the National Assembly to repeal the existing National Health Insurance Scheme Act, Cap. N42, LFN 2004, and replace it with the National Health Insurance Commission Act.
Information obtained by our correspondent revealed that the bill, which was sponsored by the Chairman, Senate Committee on Health, Senator Olarewaju Tejuoso, passed second reading last week.
One of the reforms being planned is to make it compulsory for employers of labour with at least five workers to subscribe to the scheme.
Under the NHIS Act, employers with 10 workers can join the scheme, the law does not make their participation mandatory.
However, Tejuoso told our correspondent in a telephone interview on Sunday, “We are inviting people to bring their proposals on May 17 during the public hearing that will take place in Abuja; we have not yet amended the Act.
“That is why we are holding the public hearing so that everyone can come and contribute. Majority of people want it (participation by private employers) to be mandatory; some don’t want it to be; but after the public hearing, we will come to a conclusion.”
The new bill is entitled: ‘A bill for an Act to repeal the National Health Insurance Scheme Act, Cap. N42, LFN 2004, and to enact the National Health Insurance Commission Bill, 2017, enacted by the National Assembly of Nigeria’.
The aims are to ensure a more effective implementation of a national health insurance policy that will enhance access to health care services to all Nigerians, as well as promote and effectively regulate health insurance schemes in the country.
Section 1 of the bill states that a body to be known as the National Health Insurance Commission will be established.
It explains that the principal objective of the commission will be to ensure the effective implementation of a national health insurance policy that enhances access to health care services to all Nigerians; promote and regulate health commencement; and establishes the National Health Insurance Commission health insurance schemes in Nigeria.
According to the bill, these types of health insurance schemes will be established and operated in the country: public sector social health insurance scheme to cover public sector employees and their dependants; organised private sector social health insurance scheme; mutual health insurance schemes; vulnerable group funds; and any other health insurance scheme as may be approved under the provisions of the bill.
The provisions of the bill include the establishment of schemes to be known as the public sector social health insurance schemes (referred to as the public sector schemes) for the purpose of providing health insurance coverage, which will entitle persons working in the public sector and their dependants the benefits of prescribed good quality and cost-effective health services.
The bill explains that a public sector scheme may be established by the Federal Government; a state government, including the Federal Capital Development Authority; or a local government to cover all its employees and their dependants.
It also states that a scheme to be known as the organised private sector social health insurance scheme (referred to as organised private sector scheme) will be established for the purpose of providing health insurance, which will entitle ensured persons and their dependants to the benefit of prescribed good quality and cost-effective health services as set out in the bill.
“The organised private sector scheme shall cover all employees of organisations in the private sector that employ at least five workers as well as to those individuals who may want to voluntarily join the scheme,” it notes.
The bill further explains that an employer who has a minimum of five employees will together with the persons in his employment pay contributions of such rates and in such a manner as may be determined from time to time.
According to the bill, a registered employer under the organised private sector scheme will deduct from his employees’ wages the approved amount of contribution payable by the employee.
This contribution, along with that of the employer, it adds, will be collected by or remitted to the organised private sector fund insurer for the purchase of a defined package of health care benefits for the enrolees.
It will be recalled that the NHIS Act, which was introduced more than a decade ago, had sought to alleviate poverty in the country by reducing avoidable deaths, ensuring quality health services, preventing capital flight by those patronising foreign hospitals, while also contributing to the economic development of the nation.
The scheme has continued to grow at a snail pace, leaving more than 93 per cent of Nigerians without access to health insurance.
The NHIS ensures the pooling of funds from different sectors of the economy, with many people contributing money but only a few of them actually falling ill. The essence is to guarantee free health care for the contributors whenever the need arises.
While the importance of a virile health insurance scheme cannot be over emphasized, experts have faulted the fact that majority of those on the NHIS enjoy cover only for minor ailments.
Most of the enrolees on the NHIS are public servants, because many workers in the private sector have snubbed the scheme and prefer to patronise their personal doctors for better treatment, due to complaints that the services being offered under the scheme are not in consonance with their health needs.
The Punch News