Stand Point

Health Insurance: Just before takeoff of KwaraCare



Sometime ago, a disheveled woman walked up to me, before she could utter any word I had decipher her plight. In her arms was a sickly child whose health had greatly deteriorated as evident from the physical appearance of the infant. I almost betrayed emotions at the sight of the child whose emancipated body had just thin layer of flesh concealing his skeleton. The mother whose eyes were swollen from persistent weeping solicited financial assistance to get orthodox treatment for ailing son. According to her, the health condition of her baby worsened because she could not afford hospital and as such settled for alternative medicine, which had repercussion. It took me a long while to get over that encounter. However, the truth of the matter is that she is not alone in such predicament; there abound many impoverished people going through similar pathetic situation. As a matter of fact, many die daily due to huge hospital bills while those who patronise sub-standard health facilities for cheap treatment most atimes end up in morgues. The less privileged and vulnerable groups still suffer from  financial burden of huge medical bills as there is still a high out -of- pocket payment for health treatment(s). The dire economic situation in the country is so bad that many Nigerians cannot afford going to hospitals, rather they patronise quacks and roadside drug vendors.
It is for this reason that one must applaud the Kwara State government for the launch of its health insurance scheme last Thursday. No doubt, the quest to provide efficient and effective health care delivery system prompted the Governor Abdulfattah Ahmed- led administration to establish KwaraCare, a framework to achieve the desired end-universal healthcare for Kwarans.
Health insurance is a social security system that guarantees the provision of health services to persons on the payment of token periodically.
Registration of Kwara residents for the scheme, according to the newly established state Health Insurance Agency would commence in August.
The Executive Secretary of the Agency, Dr. Olubunmi Jetawo-Winter disclosed that the registration exercise will hold for 90 days across the 193 wards of the state. Within the period the agency is expected to capture all baseline health information, and bio-data of all residents, which will form the bedrock of standardisation of operations of the scheme. It is cheering that unlike the national insurance scheme KwaraCare captures people in the informal sector.
Also commendable is the inclusion of the poor and special populations including people living with disabilities. The coverage averages to about N25 per day. The health benefit covered under the scheme include maternal and child care services, emergency care services, minor surgeries, everyday ailments, chronic illnesses such as diabetes and high blood pressure, preventive health education, among others.
The new health insurance scheme replaces the Community Health Insurance Scheme (CHIS), with the aim of ensuring wider coverage.
Nevertheless, as laudable as this health programme is, the state government must safeguard against some factors that could undermine the goals and objectives of the scheme. One of such is the problem of inadequate health infrastructure. It is pertinent that the state government ensure robust healthcare infrastructure in all public health institutions as it is only then that qualitative healthcare service can be achieved. The challenge of inadequate health workers must also be promptly addressed for the scheme to record success.
It is important that the agency must ensure that enrollees get satisfactory healthcare services in line with the objective of the scheme. The Executive Secretary of the National Health Insurance Scheme (NHIS), Professor Usman Yusuf had noted that one of the challenges confronting the scheme at the national level is the discrimination of enrollees in hospitals. The agency must therefore not condone any healthcare provider that renders unsatisfactory service. There should be periodic evaluation of state owned hospitals in order to make sure that best practices, which requires equal treatment for all patients, are adhered to. The provision of service must be such that will address health needs of each patient. Illegal charges and exploitation of patients by healthcare service must be prevented. It must be ensured that health personnels particularly nurses are polite to patients as poor attitude may discourage enrollees. Therefore, the agency in charge of the scheme should work closely with the hospitals to see how best they can serve patients, as poor service delivery by health care providers will defeat the purpose for which the scheme was established.
For impressive coverage, there should be good and implementable operational laid down strategies. In line with this, there should be massive enlightenment and public awareness of the scheme for people to realise benefits of the programme.
In addition, there is the need for the state government to ensure adequate budgetary allocation to health care for the programme to record success. It is heartening that the scheme also provides for establishment of the Kwara Health Insurance Fund (KHIF). The Fund is expected to pool resources from various sources. To ensure the scheme is well funded, the has set aside N200m  as the state’s capitalisation by NHIS while the state government on its part has committed one percent (1%) of the annual Consolidated Revenue Fund and to subsidise premium and service delivery to those considered poorest in the society.
The agency must be seen to carry out its supervisory and regulatory roles in order for the scheme to record success.
In conclusion, relevant stakeholders must support the state government in its  to provide universal health coverage to all Kwarans.

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