In the six years that Michael Adekunle worked as a machine fabricator in Osogbo, Osun State, all the money he was able to save was N95,000. Unfortunately, when he was sick last year, the money did not last more than four days in the hospital. He resorted to calling his customers who owed him to pay the debt, so that he could take care of himself. After collecting all the money from those that owed him, he sold some of his equipment and tools because he needed more money. Yet, it took the intervention of friends and family members who assisted him with some money before he got back on his feet. At zero level, Michael wouldn’t know where to start from ,and life was miserable for him as he was broke.
Unlike Michael, Olayemi Akanbi doesn’t have savings at all. He could only boast of his motorcycle that he was using for commercial purposes. Akanbi cannot forget the accident that almost terminated his life. He was unconscious in the hospital for three days and when he eventually woke up, his bill was already close to N80,000. He sold his motorcycle for N35,000 so as to settle his medical bill, but that money could not go far. While some good Samaritans assisted him to pay part of his bill, he later signed an undertaking to continue the payment of the medical bill when he is better and able to work.
The cases of Michael and Akanbi were just few out of numerous instances of less privileged who found themselves in critical situation and required some money to stay alive. A medical doctor with a nongovernmental organization, Health Finance and Governance, Dr Funto Ogundapo described such situation as catastrophic health expenditure. She noted that many people have died as a result of their inability to raise money to treat their sickness, and that those that were lucky to survive from illness have become bankrupt and probably ruined economically.
According to her, “Every second, 3 people are pushed into poverty because they have to pay out-of-pocket for health care.” Quoting the World Bank, Dr Funto said “any medical bill that exceeds 10 percent of total household income is catastrophic funding.” She maintained that all people, regardless of tribe, gender, social status, must have access to quality health care services, without experiencing financial hardship in accordance with Universal Health Coverage (UHC) goal. She expressed the need for government at all levels to address the challenge of out-of-pocket costs to curtail the risk of catastrophic health expenditure among the citizenry.
“The citizens have the rights to enjoy good health without experiencing catastrophic health expenditure. Historically, the 1948 Universal Declaration of Human Rights, Article 25 states that everyone has the right to a standard of living adequate for health, including medical care, and the right to security in the event of sickness or disability. In 1977, the World Health Assembly decided on target health for all by the year 2000 for governments and WHO. In 2012, United Nations General Assembly adopt a resolution calling for countries to toe the path of Universal Health Coverage (UHC). In 2014, there was a Presidential Summit on Universal Health Coverage in Nigeria and in 2016, UHC became a global development agenda target. It was the target 8 of SDG 3 which stipulated the need to ensure healthy lives and promote wellbeing for all at all ages. In 2017, President Buhari launched PHC Revitalization for UHC initiative.
Funto warned that poor health among the populace has serious bad consequences. “It would lead to slow progress in reducing the deaths of children under age five and maternal deaths. The country might not be able to meet Health related Sustainable Development Goals on health. There would be inequity in access to basic health services. Children from the lowest income group are 3 times more likely to die before their fifth birthday.” She explained that Health Insurance is the best way to achieve the Universal Health Coverage ,as it has the potential to save the lives of millions of people.
Apparently, the Osun state government was not oblivious of Funto’s fear. This justifies the setting up of a social health insurance scheme by the state government. The state Governor, Mr Rauf Aregbesola who set up the scheme appointed the former Chairman of the Nigeria Medical Association, (NMA) Dr Niyi Oginni as the Executive Secretary of the scheme he named Osun Health Insurance Scheme (O’HIS). Speaking at a sensitization meeting to educate the media and civil society organization on the scheme, the Special Adviser to the Governor on Health, Dr Olu’Gbenga Oyinlola said the scheme was carefully developed to help the less privileged to get treatment in hospitals without facing huge medical bills.
According to Dr Oyinlola “The essence of the scheme is to assist the less privileged in the state to be able to access medical treatment without the fear and great financial burden of out-of-pocket payment, so as to curtail the risk of catastrophic health expenditure among our people. Government will be responsible for pooling funds together to run the scheme. We painstakingly strategized it and we are sure that it would be successful. It is mandatory for all residents of this state to subscribe to it. The people will only pay a token. Also, the private providers would be involved and only the private hospitals that meet the minimum requirement would partake.”
The Health, Finance and Governance and the National Health Insurance Scheme are providing technical support to the state on the scheme to make it successful. The Coordinator of HFG in Osun state, Mr Ismaila Abdulkareem said there was need to sensitize and enlighten the people of the state to embrace the scheme.
The Commissioner for Information and Strategy in the state, Mr Lani Baderinwa said the scheme was put in place to ensure healthy living among the people of the state ,without going through catastrophic health expenditure. He appealed to the media to propagate the scheme adequately ,so that the people of the state would realise its benefits on time and key into it.
In an interview with Daily Trust, Executive Secretary of Osun Health Insurance Scheme (O’HIS), Dr Oginni assured the people of the state that the scheme would be well managed to achieve its objectives of enabling people of the state to receive quality treatment at the right time, and prevent avoidable deaths among the people. He encouraged the people of the state to key into the programme and access quality healthcare as and when due.
