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THE ROLE OF INSURANCE SCHEME IN HEALTH SERVICES IN NIGERIA

ABSTRACT: The insurance scheme health services have been playing dominant role in improving health services in Nigeria. This research work was carried out to survey the problems, abuses and effect of insurance scheme in health services.The main aims of this organization is to ensure that all its citizens receive good medical services.  Also to make available to all residents no matter the class or status, race, age and sex in need of medical care.

          Finally, to ensure that good health services can be spread to the poor and rich by payment of premium.  Also majority members of the populace receive medical services from selected health care centre without difficulties.

TABLE OF CONTENT

CHAPTER ONE

Introduction                                                                                                1

1. Background of the study                                                                   1
2. Statement of problems                                                            2
3. Purpose of study                                                                     5
4. Significance of the study                                                                   6
5. Limitations of study                                                                7
6. Definition of term                                                                    7

CHAPTER TWO

Literature review                                                                               9

1. Review of related literature                                                     9

CHAPTER THREE

1. Sources of data                                                                        16
2. Research design and sampling procedure                                17
3. Administration the questionnaire                                            18
4. Collection of data                                                                    18
5. Measuring instrument                                                             23

CHAPTER FOUR

1. Presentation and analysis of data                                            25

CHAPTER FIVE

1. Recommendation                                                                     31
2. Summary                                                                                 32
3. Conclusion                                                                              33

Bibliography                                                                           35

 

CHAPTER ONE

 

INTRODUCTION

1. BACKGROUND OF THE STUDY

It is been said that health is the most important thing a human life.  But before I delve into the steps that will be taken by the Nigerian government to institute a health insurance scheme, it is necessary to have an idea of what the federal government and some state governments have done in the area of health insurance scheme for the country and some states.

          On August 23rd 1985, the minister for health, Chief (Dr) Emmanuel Nsan inaugurated a special advisory committee on National Health Insurance Scheme in Nigeria to examine issue related to health insurance scheme as a National Health Insurance Scheme as a way of financing personal health care services.  The terms of reference of this committee were:

1. To examine the feasibility of the National Health Insurance Scheme in Nigeria.
2. To advise on the modalities for the implementation of such a scheme.
3. To examine any other matter which in the consideration of the committee is deemed relevant to the operation of a workable health insurance scheme in Nigeria.
4. To  make recommendations

 

1. STATEMENT OF PROBLEMS

The usual problems associated with the scheme are many and in our society they will even be more, some of these are

1. Level of sincerity in billing by hospital.  It is always common that hospitals send fantastic bills or are in collusion with the users of the scheme.   This problem will be solved if a pre agreed amount is fixed for each type of illness.
2. Settlement of bills when cases are referred to other hospitals not in the group.

In many cases there are referred cases to hospitals not listed in the group and settlement of their bills becomes difficult since they are not bound by the standard which are applied to hospitals in the group.  These hospitals should be made to abide by the charges for those in the group otherwise the user or the organization may have to pay higher amount for the cost.

1. Managerial decisions involving abuses Health Care Organizations and Monitoring the system.

Having set the system, it is important to set up the various parameter for monitoring the scheme.  It is the physicians who manage the health care organizations even though non – physicians may carry the title of administrator.  Even though these doctors are highly qualified in their various disciplines, they do not have the technical know-how to perform the role of administrator in health insurance scheme.  The physicians and insurance companies do also cooperate in controlling unnecessary costs by participating in the peer review committees that evaluate utilization patterns.  These committees composed of doctors have been used in a number of areas to oversee medical reimbursement, limit overpayment and deter furture over utilization abuses.  It is known that these schemes have been successful in many occasions especially when they are organized by the doctors themselves. The bad moral aspect mentioned also is that our people will tend to collude with hospital in order to defraud the insurance scheme by feigning to be ill while they are not.  They could also send relations or members of the public who are not covered by insurance schemes to hospitals and forward the bills to the insurance scheme for settlement.  Other abuses are in the areas of prolongation of stay in the hospitals as an ordinary healthy person could decide to go to the hospital to get some rest and pass the bill to the scheme to pay.  The problem of increased charges when the patient is insured is a particularly serious one.  There is no reasons for those with insurance to be charged more than those without insurance.  If those without insurance who have been prudent should try to provide for their health expenses through the advance payment of premium should in the end have to pay more for medical services than if without insurance, then the effect will be penalize them for the foresight of those who insured.

4.       Lack of statistics and records

          It is unfortunate that there are no available statistics in most of our hositals regarding the number of patients who attend hospitals and the type of diseases or illnesses they are treated for.  There are also no statistics fo relapses or recurrences of such illnesses.  It is my view that this workshop should consider seriously the issue of maintaining statistics of those who attend hospitals and the illnesses for which they are treated at hospitals and to make it possible for anybody to obtain this information to enable both doctors who fix rate of premium and the insurance companies to determine the basis of their rating.

 

1. PURPOSE OF STUDY

The purpose of this study will be to evaluate the role and strength of the insurance scheme in health services in Nigeria.

1. To make recommendations in the modes of operations and other matter as may be considered relevant to the establishment of the scheme.
2. To  examine specifically the policy implementation, planning arrangements ad any existing or potential administrative structure that may be required for a timely introduction of the scheme.
3. To examine the phase in of the implementation of the scheme and advise on a time frame for its implementation.
4. To examinein the light of the recommendations made in previous rpeorts on the subject,  the establishment of health insurance scheme as an option for funding health care services in Nigeria.
   
   
   
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