When the National Health Insurance Scheme (NHIS) was officially launched on June 6, 2005, it was heralded as a bold step toward achieving universal health coverage in Nigeria. Its primary objective was clear: to protect citizens, especially workers and their families, from financial hardship resulting from exorbitant medical bills. The NHIS was designed to distribute healthcare costs equitably, ensuring that medical care would be accessible and affordable for all enrollees, regardless of income level.
However, nearly two decades after its inception, the NHIS appears to have drifted from its founding mission. For many Nigerian workers and eligible beneficiaries, the scheme has become a source of frustration and despair. Allegations of maltreatment, poor service delivery, and outright neglect are increasingly coming to light, prompting questions about the true state of the program.
One of the most troubling realities is that NHIS beneficiaries often feel compelled to hide their insurance status to receive quality care. Instead of presenting their NHIS cards, some patients opt to pay out of pocket, preferring to sacrifice their limited earnings rather than face the disdainful treatment meted out to insured patients. This practice underscores a troubling dichotomy in Nigeria’s healthcare system, where hospitals tend to prioritize patients who can pay cash, while NHIS enrollees are pushed to the margins.
Reports from various healthcare facilities suggest that NHIS patients are treated as second-class citizens. There are often unspoken divisions in hospitals—separate queues, different drugs, different rooms, and even varying standards of care depending on a patient’s payment method. While private patients may receive comprehensive medical attention, NHIS patients sometimes leave with little more than paracetamol, regardless of the severity of their ailments. This has left many workers traumatized, disillusioned, and emotionally drained by the very system meant to safeguard their health.
At the core of the NHIS is a promise to pool resources and spread the burden of healthcare costs across different income groups. Yet, Nigerian workers who contribute monthly to the scheme find themselves neglected at critical moments. The pressing question remains: why are these contributors denied quality healthcare when they need it most?
The situation is further complicated by allegations of corruption and sharp practices within the system. There are claims that some healthcare providers apply for drug approvals through the NHIS but later inform patients that the drugs were not approved, forcing them to pay out of pocket. This practice raises serious concerns about transparency and accountability in the management of the scheme. If true, it undermines the very essence of the NHIS as a social safety net for Nigerian workers.
Maternity care under the NHIS is also fraught with challenges. The scheme officially covers four pregnancies resulting in live births per enrollee. Yet, there are widespread reports of hospitals demanding additional payments from women during post-natal care, sometimes disputing the eligibility of live births to avoid offering free services. This exploitation places undue financial and emotional stress on expectant and new mothers, many of whom cannot afford the additional costs.
The growing discontent with the NHIS suggests a system in urgent need of reform. To restore trust and ensure the scheme serves its intended purpose, there must be concrete steps toward improvement. The NHIS could begin by establishing direct communication channels between enrollees and Medical Health Officers, creating platforms where complaints can be promptly addressed. Additionally, there is a pressing need to educate enrollees about their rights, coverage details, and how to navigate the system effectively, thereby reducing misinformation and preventing exploitation.
Without swift and decisive action, the NHIS risks becoming a failed social policy, widening inequalities rather than bridging them. Nigerian workers deserve better from a system they fund. Their right to quality healthcare must be respected, and the allegations of maltreatment and poor services demand thorough investigation and urgent explanation.