The National Health Insurance Scheme (NHIS),at the weekend said that the scheme does not cover some major ailments because only an insignificant number are affected by them in the country, but unfortunately they require high cost of care to treat or manage.
The acting executive secretary, NHIS, Dr Abdulrahman Sambo, made this known at the Enrollee’s Forum in Abuja.
Sambo who was represented by the General Manager, Technical Operations, Dr Hope Uweaga, said that the scheme is always reviewing cases for coverage, though those ailments presently not covered are very few.
He said, “Were NHIS to cover it, the premium you would require workers to pay for providing that little additional cover, would be very high cost that they would be unable to bear. Take dialysis, for instance. Initially it was not covered but now it’s being covered. But when you talk about ailments like IVF, they are very expensive procedure. Were we to cover it, the cost burden for our enrollees would be too high. But I can tell you something, it is a continuous process.
“We have Nigerians living in the rural areas who are dying of very minor ailment. So we need to be pragmatic. We need to show equity so that before providing those kinds of things, we should have at least been able to take care of more than 80 per cent of Nigerians who do not have access to basic health services.”
Sambo, however, disclosed that the scheme has one of the the best comprehensive health packages in the world, saying, “I have had the privilege to study various health insurance programmes of both emerging and advanced economy. The NHIS benefit package is about the most comprehensive anywhere in the world. There is no insurance programme that covers all the details because insurance is about financial interpretation. It is the amount you ask employers to pay that determines the amount of care that you can provide.”
According to him, the scheme covers 100% at primary level, over 100% at secondary level and over 90% at tertiary level.
Sambo who was represented by the General Manager, Technical Operations, Dr Hope Uweaga, said that the scheme is always reviewing cases for coverage, though those ailments presently not covered are very few.
He said, “Were NHIS to cover it, the premium you would require workers to pay for providing that little additional cover, would be very high cost that they would be unable to bear. Take dialysis, for instance. Initially it was not covered but now it’s being covered. But when you talk about ailments like IVF, they are very expensive procedure. Were we to cover it, the cost burden for our enrollees would be too high. But I can tell you something, it is a continuous process.
“We have Nigerians living in the rural areas who are dying of very minor ailment. So we need to be pragmatic. We need to show equity so that before providing those kinds of things, we should have at least been able to take care of more than 80 per cent of Nigerians who do not have access to basic health services.”
Sambo, however, disclosed that the scheme has one of the the best comprehensive health packages in the world, saying, “I have had the privilege to study various health insurance programmes of both emerging and advanced economy. The NHIS benefit package is about the most comprehensive anywhere in the world. There is no insurance programme that covers all the details because insurance is about financial interpretation. It is the amount you ask employers to pay that determines the amount of care that you can provide.”
According to him, the scheme covers 100% at primary level, over 100% at secondary level and over 90% at tertiary level.
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