Dear Millennial, You Need Health Insurance Too
Kene is a 25-year-old freelance programmer. He makes good money from the comfort of his home, does not go out so much, and his girlfriend, Tinuade, a banker, lives only two streets away. Kene’s parents stay on the other side of town, and apart from occasional game nights, and the regular dates with bae, he only goes out to visit his parents.
One day, on his way back from one of such visits, he has an accident. He is rushed to 3 different hospitals before he ends up at a government hospital. His condition is critical by then, he has lost a lot of blood, and his life is hanging by a thread. Tinuade, is by his side, because, the good people who found him bleeding out on the floor were able to unlock his phone, and call his last dialed number. She has called his parents, and she is trying to be strong. Kene’s breathing is shallow, she can feel his grip weakening, and the doctors are working in a frenzy, trying to stop the bleeding temporarily, pumping fluid into him as well. There is only one problem, Kene requires an exploratory laparotomy. Kene, now conscious, but very weak, tells Tinuade the pin to his atm card, and she hurries to the atm machine close by. His account balance is only N75,000, barely half of the money needed.
Kene is an avid saver you see, and most of his money is tied up in low to medium risk investments and securities. A good plan, but now, he is dying, and he needs money to pay for his surgery. Money he cannot easily access at 1 am. The doctors are working on getting a waiver for the management, but time is ticking. Tinuade empties her account, and luckily, they have just enough for the surgery.
The doctors wheel him in, they battle for hours, and Tinuade is left weeping in front of the theatre. Kene’s parents show up, and soon, Kene’s father has two women weeping, and holding onto him. His eyes are heavy too, and even his gray hair has lost its sheen. His heart beats furiously, and he feels pain spread from the centre of his chest and engulf his entire body. He must be strong, he whispers to himself, they stand there,waiting. Eventually, the long wait ends. The theatre door swings open, and the surgeon walks out, his face is weary, and his eyes say the words before he utters them. Kene is saved.
Kene could be any one of us, young people often feel invincible, and truth be told, we largely are. We work ourselves weary, and go to sleep with aches that heal overnight. The next morning, we are up and kicking, hale and hearty. Hence, we often do not feel the need to invest so much in our health. If Kene had health insurance, his story would have been different. Kene lived in this story, but how many are that lucky?
Death is inevitable for every human. But some deaths are preventable, negotiable even. Our poor emergency system, and our largely out of pocket-based health financing system, and bureaucracy are some of the factors that connived to take Kene away from us. These are but a few of the problems that plague us. Many people are toiling day and night in the health industry to make these problems fables of the past. It will take time, and given our government’s lack of commitment to health care, case in point the AU’s Abuja Declaration of 2001, was an agreement to spend 15% of the annual budget on health. In the last 10 years, the highest we have spent is 5.8% in 2012 & 2015, in 2019, it was 4.1%. (ICIR Nigeria, 2019), it is save to say that the health of Nigerians lies largely in the hands of the private sector.
Nobody plans for illness, and truth be told, having a health savings account, as is done in some countries like Singapore, may not be enough to cover for possible health problems. Catastrophic health spending led to 0.8% increase in poverty i.e. 1.3 million Nigerians in a study carried out over a one-year period (Bolaji Samson Aregbeshola, 2018). The study further revealed that better off households were more likely to be affected. This shows that catastrophic health spending is more likely to affect the fast disappearing middle class in Nigeria. I believe in solutions, not just in highlighting problems. One major solution to mitigating the effects of catastrophic health spending, and ensuring that people like Kene are not tilted into poverty, or worse still death, is health insurance.
I admit that the NHIS scheme is yet to fully live up to its mandate over 14 years after the reforms of 2005. I also admit that health coverage is less than 5% of the total population (Awoyinfa, 2017). In essence, the system is a largely failed one, but there is still hope. All is not lost.
Earlier in the article, I spoke about the private sector toiling day and night to proffer solutions. I do not intend to paint the private sector as knights in shining armor, after all, the private sector is largely driven by profit (which is hardly anyone’s fault, as money is to be made in order to pay bills, and provide for one’s self and loved ones), however, one cannot deny the role the private sector plays in development, and the betterment of life. Private health insurance is one of such innovations, it may not be perfect, but it is, I daresay, at the moment, the best bet of the average Nigerian.
If Kene had health insurance, accessing care would have been easier, and faster. Many Health Management Organizations exist in Nigeria today, and I will expand more, in subsequent articles on the role of HMOs in health insurance, the role they currently play, and other added benefits they can offer enrollees.
Kene is all of us really.
Daily, we ply the roads in search of our daily bread, or in order to seek love and comfort, in churches, mosques and the homes of those we love. Accidents are not the only route to sudden, unexpected, and probably catastrophic health expenditure. The human body is not perfect, and things can go wrong. The aim of this article is for everyone to be prepared, don’t be caught sleeping on a bicycle. Out of pocket payment for health ruins families and individuals every day, don’t let it ruin you. Get some form of health insurance today!
References
Awoyinfa, S. (2017, August 10). Less than 5 % of Nigerians covered by NHIS. Retrieved from www.punchng.com: https://punchng.com/less-than-5-of-nigerians-covered-by-nhis/
Bolaji Samson Aregbeshola, S. M. (2018). Out-of-Pocket Payments, Catastrophic Health. International Journal of Health Policy and Management, 9.
ICIR Nigeria. (2019, Jan 1). Nigeria remains perpetual defaulter of the ‘Abuja Declaration’ on health funding. Retrieved from ICIRNigeria.org: https://www.icirnigeria.org/nigeria-remains-perpetual-defaulter-of-the-abuja-declaration-on-health-funding/#targetText=This%20was%20the%20main%20premise,by%20the%20'Abuja%20Declaration'.
