Achieving universal health coverage through health insurance amid naira scarcity

SINCE the 2016 second recession wave in Nigeria, and the impact of the coronavirus pandemic from 2019, Nigeria has suffered an enormous economic decline which has led the government to obtain loans from other countries in order to resuscitate the economy and improve livelihood.

  The COVID-19 pandemic did not only pressure healthcare systems but also plummeted the Nigerian oil price by 60%, pushing most Nigerians to hunger and poverty because the oil sector accounts as the primary source of the Nigerian revenue. A notable effect of the COVID-19 pandemic is the loss of jobs by many. Recall that, before the pandemic, the Nigerian Bureau of Statistics reported the unemployment rate in Nigeria as of 2018 to be around 43%. Added to the inability of farmers to farm during the COVID-19 pandemic, the economy of Nigeria drastically decelerated, leading most people to fall below the poverty line. While the Nigerian government is interested in stabilising the economy, it is no lie that Nigerians are suffering from other alarming situations such as insecurity and poor healthcare systems.

  The Central Bank of Nigeria in January 2023, began the process of implementing the cashless economic system, which is aimed at scaling financial inclusion in Nigeria and also reducing the rate of other financial related crimes such as kidnapping, armed robbery, terrorism financing, ransom payment, etc. Despite the positive intentions of this policy, which also included the modernisation of the Nigerian payment system, this policy experienced a lot of resistance to its complete fulfillment. Some of the challenges experienced were the unstable bank networks for online banking, which particularly accelerated the decline of many business activities, especially for Small and Medium Enterprises (SMEs) and the inability to do business with the unbanked. However, regardless of these hindrances, the character portrayed by most Nigerians illustrated that people would generally seek immediate ways to adapt, improve and resolve situations that affect their finances.

  During the events of the cash scarcity, many unbanked Nigerians saw the need to open a bank account and learn how to use mobile banking within a few days. Most Nigerians immediately opened accounts through seamless services provided by various financial organisations. However, we cannot negate the deaths that would have resulted as a result of lack of cash to pay hospital bills and unstable network systems to make urgent and immediate money transfers for medical bill payments, especially at the early stage of the naira scarcity when most hospitals had not adapted to providing a Point of Sale (POS) machine at their hospitals or receiving of online transfers.

  Certainly, one would not bother about cash payments or even paying at all for their medical bills if they have health insurance coverage. Alas, according to Detaphyte, only 3% of Nigerians have health Insurance. Healthcare induced poverty, and the inability of people to access proper healthcare services due to financial limitations is a global concern and goals have been set by organisations such as the UN, World Bank, UNICEF, and WHO to resolve these challenges. An example of this goal is the Sustainable Development Goal 3.8 which is achieving Universal Health Coverage (UHC) by 2030. The Universal Health Coverage goal means that everyone can access healthcare without experiencing healthcare induced poverty or healthcare financial burden.

  There are various ways this goal can be achieved. For example, the government can choose to provide absolutely free national healthcare systems, or health insurance organisations can step in to bear the cost of medical treatment. Considering the current economic situation of Nigeria, the easiest and most realistic way to actively promote the achievement of UHC is through health insurance. It might interest you to know that achieving UHC is critically important for Nigerians. In July 2022, the World Health Organisation (Dr. Francis Nwachukwu Ukwuji) reported that about 80% of the Nigerian population are sliding into healthcare-induced poverty. One may wonder how true these statistics are so it is important we make a quick analysis.

  According to Statistica, the average Nigerian earns a gross salary of around N75,000 monthly. This money is expected to cater for housing, healthcare, feeding, transportation, clothing allowance, career development, etc. Now, in situations of severe health needs, such as surgery, antenatal, chronic health management, etc, which would usually cost around an average of N200,000 monthly, you can now clearly see that the average earning Nigerian is at the risk of healthcare induced poverty. It can simply be said that despite the presence of health insurance organisations in Nigeria, around 80% of Nigerians are either uninformed of health insurance services or are unwilling to use the health insurance services until there is an escalation.

  In a bid to support universal health coverage in Nigeria, health management organisations have established retailed health insurance plans starting from as low as an annual cost of N20,000 for an individual, to enable them access standard healthcare services including surgeries, accident cover and even antenatal care. The challenge however is that for much impact to be felt, the government has to be involved. Just as the National Identification Number is an essential in Nigeria, having health insurance coverage should be an essential for a Nigerian citizen. The government, therefore, has the responsibility to make policies that will drive healthcare sustainability in Nigeria because healthcare policies play a vital role in supporting national wealth, resources, and the general population’s health. The government and health insurance organisations should increase sensitisation on health insurance especially to remote area residents.

  Additionally, the government should make policies that are geared toward supporting private health insurance organisations to provide an affordable health insurance plan. We do not have to wait for healthcare financial crises before we start to do the right thing. At the time of the naira scarcity, most people wished they had an ATM card or even knowledge of how online banking works. It was a time of financial chaos that also affected access to healthcare. As a people, we need to take responsibility as well while the government does its part. The benefits of health insurance cannot be over emphasised. As a matter of fact, the sense of healthcare financial freedom will make people pay more attention to their health and quickly seek medical attention at the slightest need. Individuals should therefore  make haste and contact a health management organisation and purchase a health insurance plan either as an individual, a family, or even as an organisation.