A Naija doctor shared his experience treating an okada man who was brought to him bleeding after a collision. He cleaned and sutured the victim’s wounds, gave him drugs, but the okada man disagreed with the N20,000 he was billed. Not only did he disagree, he returned with a mob of his fellow okada men to threaten the doctor with physical violence. The doctor, concerned for his safety was forced to waive the full cost of the treatment.
Other doctors in the comments shared similar stories: one spoke of a patient who hadn’t been discharged jumping a fence to avoid paying; another recalled a patient who borrowed cab fare from the doctor with a promise to return with the money for his treatment but never came back. These experiences have understandably changed how these doctors deal with patients. Some will now only perform basic first aid if they receive payment upfront.
I admit that I’ve always been one to advocate for treatment first before asking for payment. Medical professionals do take an oath of care after all, and a healthcare system that prioritises payment over treatment risks unnecessary casualties.
A woman I knew in Belgium—a mother of two young children and a wife—was in Nigeria on holiday when she had a car accident. According to what we heard, by the time her family in Naija were identified and notified of her accident and found the hospital where she’d been taken to, she was dead. Per gist, the doctors at the hospital refused to treat her as none of the Good Samaritans who brought her would pay for her treatment. What could have been a survivable incident became fatal for her.
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However, having read these stories from doctors on Twitter, while my position hasn’t shifted, I have gained some understanding of the sort of circumstances that could lead to such strict rules that put payment above care. I still believe that healthcare professionals are duty-bound to treat patients, but I also believe that they deserve to be paid for doing so. After all, these doctors and nurses are also individuals, some with families dependent on them, trying to survive our country the same as everyone else.
Their service doesn’t provide them with a magic tree in their backyard that grows money, No one wants to labour in vain. Ndi Igbo say that the person who plays the lute must also wipe his mouth.
A Twitter user shared the story of his brother’s wife who had surgery but whose husband only paid half of what he was billed because “wetin doctor do, small stitches here and there and una wan collect that kind money (?)” It’s not fair to expect that these professionals treat patients who then refuse to pay because they can’t pay or because they don’t believe that the treatment they got warranted the amount they are billed. Who wants to come out of hours of performing surgery to be confronted by their patient’s spouse bargaining over the cost of treatment as if they were bargaining over the price of groundnut?
These incidents highlight the urgent need for expanded health insurance in Nigeria so that health care providers can work knowing they will be fairly compensated, and patients don’t have to put themselves in danger trying to dodge payment.
The NHIA Act of 2022 gave Nigeria’s health insurance authority a mandate to provide insurance to all Nigerians and residents of the country through a mandatory health insurance scheme. Yet, per a Lancet report, over 90 per cent of Nigerians still pay out of pocket for medical care.
Coverage remains limited due to, among other things, lack of awareness and infrastructure, especially in the rural areas. Banks, mobile phone companies, and other organisations can play a role in raising awareness and making it easier for people to access health insurance.
Health spending isn’t just about care—it helps the economy grow. A healthy nation is a wealthy one abi? Higher productivity and all that. When people are forced to stay home rather than get medical help when they need it, or when our healthcare professionals are forced by necessity to limit treatment because they are not sure they will get paid, everyone pays the price.
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