In the mornings, they loiter around the hospital corridors, wards and clinic; their faces wrinkled with lines of worry and desperation. In the evenings, they can be found perambulating around the car parks, shops and business centres. All of them with one request: financial assistance for a family member on admission.
Have you ever faced a sudden hospitalisation situation where you had to arrange for a large amount of funds within a short period of time? If yes, then you would understand how difficult it is to arrange funds on a short notice.
Unfortunately, every time financial experts advise about saving for rainy days, they neglect to factor in health emergencies. Well, this is 2024 and ‘Sapa’ dey everywhere. In other words, there is no money, anywhere.
In one of our many training workshops on financial management for health workers, a professor asked the class- ‘If you retire at age 60, how many of you can afford a year’s dialysis without selling a plot of land or house?’
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Nobody answered.
‘OK- what about six months? Can you afford six months dialysis?’
Yet, none of us raised our hands.
‘How about three months?’
A few hands in the air.
‘And you consider yourself rich?’
In the lecture, he emphasised about the need to save for our health as we grow older. People who brag about ‘never been admitted in a hospital’ are incredibly naïve to the nuances of advancing age. The older we become, the higher our risks of Non-Communicable Diseases (NCDs) like Hypertension, Diabetes and Osteoarthritis and their accompanying complications. And these are the milder diseases. When you are diagnosed with End-Stage Renal disease (ESRD) or cancer, the cost implications are much higher that can be ever imagined. Even the corrupt ones that have stolen billions, die in penury. This, I have witnesses more times than I can count. Truth is, many of us are just one chronic illness away from poverty.
With illness, there are two types of cost: direct and indirect cost. Direct cost includes cost of medication, surgery, travel etc. Whereas indirect cost is expenditure that arise as a result of the illness. For example, if you were once hale and hearty and able to drive yourself, glaucoma will make you hire a driver. If as a woman, you were strong and able to do all house chores, osteoarthritis will make you look for hired help. And if you are diagnosed with a terminal progressive illness, then you will have to consider getting someone to move in and live with you, permanently. Even in Africa, where caregiving is informal, the patient soon realises that he or she will have to ‘assist’ the care giver financially so as to receive optimum care. As the saying goes: ‘There is no free lunch’.
Not everyone can exercise patience and exhibit gratitude when there is such a severe lack of control on one’s life and its basic functions. How can we even prepare? How can we deal with our age, infirmities, illnesses and the inevitable end? How can we try to make it better for ourselves and for others who care for us?
Well firstly, as our professor told us several times, is to take charge of what you can. Begin today. You are responsible for your health. Be determined to live healthy and take care of what you can. Keep fit and flexible and be determined to remain as independent as you can. By making healthier food choices, you can prevent or treat some conditions. These include heart disease, stroke, and diabetes. A healthy diet can help you lose weight and lower your cholesterol, as well. Exercise daily and stay away from tobacco and alcohol. Screen regularly for common illnesses. Practice safe sex; as the popular saying goes, HIV no dey show for face. Get vaccinated and stop listening to social media conspiracy theories. If the west wanted to kill us, we would have been wiped out eons ago.
Secondly, allocate a portion of your current income to your health and wellbeing. Invest in yourself. Without the commitment of time and money your personal goals will remain on paper. Don’t keep a complicated financial life. You don’t want to lose control of your health and spend your last days worrying whether you told your children about the plot of land in the native village; the unpaid loan to a dear friend; or the unclaimed bond that matured last year. Keep your affairs simple, well listed and operational. Make it easy for others to use your money for your health needs if the need arises. Make it easy to delegate and hand over.
Thirdly and most importantly, get health insurance. There are different types of insurance schemes in Nigeria but all fall under two groups- public and private health insurance. Public health insurance in Nigeria is governed by the National Health Insurance Authority (NHIA). It began operating in 1999 by the National Health Act and aimed to provide community-based health insurance and achieve universal health coverage. To achieve this universal coverage, the federal government provides the public durable and cheap medical care in exchange for subsidised premiums. Most civil servants working in the Federal Government and state government (under the state government schemes), uniformed personnel and private sector employees are enrolled in this type of insurance. Public health insurance also covers the vulnerable and those in the informal sector provided they are willing to join the scheme.
Private firms issue private insurance in Nigeria to the public through health maintenance organizations (HMOs). This kind of insurance works such that those who need it can choose what coverage they want and can afford. Hausa people say: ‘Iya kudinka, iya shagalinka’.
The importance of having health insurance is enormous. In addition to access to healthcare and obtaining medication at only10% of the cost, many procedures that would otherwise be financially daunting, can be done at 50% of the cost. Additionally, other family members can be added as dependants and care can be obtained even after retirement and in old age.
Even with these precautions, health care will make a hole in the pockets for those fortunate to live till their eighties and nineties.
Therefore, let us make this our second new year resolution: to be intentional about living healthy and to save for our health. Keep money aside for ill-health and get an insurance.
‘Betta’ to be prepared than to be caught unaware.
