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By Henry Uche
During a recent media tour of some Pension Funds Administrators (PFA) in Lagos, I interacted with some ‘Senior citizens’ as retirees are fondly called. Seeing and talking with these aged men and women was on the one side a fun to me, particularly as a few of them gladly told me that now they are free of routine and regulated lifestyle, they feel better- These are few lucky ones.
There is another crop of retirees I saw whose physical look and utterances evoked pity and gloom. One Pa Joseph Adisa’s case pulled tears down my cheeks; and people in the class of Pa Joseph are many. They have some things in common: Wrinkled faces, fragile -looking, unkempt and each with one health complaint or another. For Pa Joseph, he is a diabetic patient with an appalling wounds. In the course of our chats he told me he had the problem while he was in active service in a state civil service. Then I asked him, why or whether he was not under any healthcare arrangement, his lamentation of how much he had expended on the illness proved to me he was not aware of an health insurance policy.
People like Pa Joseph Adisa abound- who do not know alternative means of managing health problems. As a journalist, I decided to make it my concern to help more people become aware of how to save for the rainy days about their health through insurance cover.
If many Nigerians were asked about insurance policy and premium; what they know the most are fire insurance, car accident insurance, burglary insurance, (third party motor insurance) and Life insurance. You, the reader of this article, how much do you know about health insurance policy? With the level of depression and other mental and health challenges in the country of late, one needs to commend the Lagos state government for an initiative tagged, ‘ILERA -EKO’ translated to mean – Lagos Health and Wellness; this is a typical health insurance scheme as practiced in civilized climes.
A health insurance policy is a voluntary arrangement between you as a policyholder and a reputable health provider agency that agrees to help manage your health conditions at a modest fee. As in all insurance contracts, payment of money known as ‘Premium’ is the hallmark of the agreement. A health insurance policy is a package of medical benefits which covers health activities such as medical tests, drugs administration and treatments services. Some policies cover medical expenses including surgeries.
Why do we need health insurance?
With a cue from Pa Joseph’s experience, no one plans to fall ill or get hurt but a serious illness can strike anyone at any time. The cost of treating such illness can cause severe financial strain on the savings one has accumulated over time. This could affect several other plans like Children’s continuous education, maintenance of property and social lifestyle. The benefits of life insurance policy outweighs the premium paid by an enrollee. For instance, the ILERA -EKO scheme is a unique and compressive package for Lagosians. It has such layers of interests like:The standard plan, the telemedicine plan, the senior citizens’ plan which is for people like Pa Joseph that are above the age of Sixty years and battling with a Life – threatening illness, among other plans.
How is Health Insurance Scheme (H.I.S) different from prevailing System of routine visit to public hospitals?
As with every new scheme, people are often wary about its workability or benefits. People wants to know; Is this not a ploy by the government’s bureaucracy system to remove the prevailing social benefits on healthcare and consultations in public hospitals? These and several other questions were asked on the day the ILERA EKO health insurance scheme was launched, in Lagos. As a journalist, one is concerned more with balancing the scale between what the people earnestly expects and what the government is really offering them.
An enrollee handbook offered a few responses and one trust that, the promoters of the scheme would try to make it more comprehensive to address the health concerns of everyday people by providing tangible proofs as an assurance of honesty, transparency and accountability of the scheme.
Procedure to access H.I.S benefits
The fact remains that social health insurance scheme is available healthcare delivery system citizens enjoy having succeeded in advanced societies. It’s a good option to run health management in highly – populated societies. And as its promoters say, it’s was going to be the bedrock of healthcare delivery in the emerging -smart- metropolitan Lagos. This being the case, it’s only advisable that Lagos residents begin early to understand and adopt the scheme.
Does H.I.S include Primary Healthcare?
Primary Healthcare delivery is a formidable health programme at the local government level across the country, designed by the World Health Organization, WHO, to facilitate universal health coverage in spite of few limitations. The H.I.S is still a health programme which is dependable, accessible and affordable to many Nigerian rural dwellers. One wonders whether the innovation of H.I.S in Lagos state would sustain primary healthcare services at the suburbs of the state.
The experience of federal government civil servants with the national health insurance scheme, NHIS, may be a thing of concern which the promoters of ILERA EKO would want to study and address.
Federal workers under the NHIS programme often complain that their patron hospitals are very selective in their dispensary of crucial drugs; more so inadequate consultancy attention on special cases like neo- natal services, dental care and other emergencies are order of the day.
Since wealth is a function of healthy living, it is a good thing that the ILERA EKO plan is rather comprehensive with broad benefits. Something like wider choice of primary care services, healthcare providers- network and efficient referral system from primary to tertiary providers. When these promises are guaranteed, one hopes that the Lagos version of health insurance scheme is truly unique.
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