By Abubakar Barde
It is an easy deduction that when a nation’s economy progresses, its health also improves but the less obvious reasoning is the fact that the reverse also holds as much true. Another less obvious fact about good health especially in a developing country is the fact that affordability of healthcare if not more than, is as important as availability. Very early into Nigeria’s independence, the Universal Health Coverage (UHC) took a center stage with the then Minister of Health, Dr. M. A. Majekodunmi, submitting a bill to the parliament in 1962. Though the bill suffered rejection from some bodies, it heralded the need for health insurance in Nigeria and it was to suffer different fates through different administrations and Health Ministers but prominent among the Ministers of Health who pushed for it include Admiral Patrick Koshoni (1984), Prof. Olikoye Ransome –Kuti (1988), and Prof. Eyitayo Lambo (2005). The most significant milestone for health insurance in Nigeria came with its enactment as National Health Insurance Scheme Act 35 of 1999 constitution as amended. The scheme endured several administrative bottlenecks until 2005 when it formally took off with the Federal Ministry of Health Supervising, but under the stewardship of an Executive Secretary.
In July 2016, the President Muhammadu Buhari Administration appointed Prof. Usman Yusuf as the Executive Secretary, National Health Insurance Scheme, and less than a year into office, the scheme has experienced a whirlwind of transformation in terms of administration and service delivery. A professor of Hematology and seasoned by three very distinct healthcare systems, Usman Yusuf has come with a wealth of experience that is already yielding positive results within a short period. His about 35 years of practice has seen him through the Nigerian, UK and American Healthcare systems has accorded him the tenacity to revamp and restructure the otherwise shaky system of NHIS that he inherited.
The major stakeholders of NHIS are the public and private service employees who are the direct beneficiaries of the scheme, the government enable, subsidise and regulate the healthcare service provision, the Health Maintenance Organisations (HMOs) which are formed by public and private sectors to collect contributions from employees and employers on behalf of Service providers who in turn. Provide the healthcare services to the beneficiaries. After a rigorous exercise of consultations, investigations and deliberations, the Executive Secretary discovered that the major challenges faced was the unimpressive services given to the beneficiaries was as a result of inadequacy in payment by the HMOs. Several among the 60 existing HMOs were not paying the service providers promptly in addition to the fact that fake enrollees were added into the scheme for selfish gains. This saw to the discovery and cancelation of 23, 000 fake enrollees and 92% refunds made to the NHIS by the HMOs.
Besides the administrative clean up, Prof. Yusuf has displayed tenacious dedication towards greatly widening the beneficiaries of the NHIS to include those who are of much less financial strength. His administration has also shown willingness to work with the Nigerian youths and incidentally, the The Tertiary Institutions Social Health Insurance Programme (TISHIP) is a programme that stand to benefit university students which has been introduced since 2014 but has remained unpopular among Nigerian youths, which is an aspect that NHIS is willing to re-orient Nigerian students and we the well-meaning youths of Nigeria must stand to be counted as active drivers of such an initiative.
As expected, those who have been living fat off the broken system of the NHIS would oppose to any change that cuts the supply of oxygen fanning their corrupt practices. Prof. Yusuf is not without a few that are using various means to go against his drive and policies, but ultimately, he has the support of the Presidency, and the teeming youths of Nigeria, and our prayer, is Prof. Usman Yusuf achievements, can be replicated in other health sectors in Nigeria so that instead of the health sector to wait to be revived by economic development, let the health sector lead a revolutionary growth of the nation’s economy.
Abubakar Barde, a Youth leader and social activist, wrote in from Abuja.