Financing healthcare in Nigeria has been a subject of concern to stakeholders, and the Secretary General of Nigeria Medical Association, NMA, Dr. Olukayode Akinlade did not mince words while presenting paper on “Healthcare Financing in Nigeria: Options and Possibilities” at the just concluded Healthcare Summit held in Ilorin.
Reviewing Dr. Akinlade’s paper, the following emerging factors are the highlights as well as five essential ways to finance healthcare delivery.
According to Dr. Akinlade it is widely accepted that the public healthcare delivery system in Nigeria has virtually collapsed due to government funding constraints and interplay of other socio-economic crises, thus making it impossible for government to cope well with the provision of healthcare to the populace. This situation has been exacerbated by inadequate budgetary allocation, inefficiencies in the current system, rapid populations growth and the emergence of new diseases and challenges.
Healthcare is unique because it is needed most by the people who are unable to pay for it. Many Nigerians are so impoverished that further demands on them for out-of-pocket expenditure on health care as against shelter, food and education often result in increased poverty and subsequently increased risk of disability and eventual death.
Healthcare financing should involve a sound knowledge or information of how health services are financed and in particular, how much is being spent to provide healthcare services, what goods and services are being delivered and who is paying for them.
FIVE WAYS TO FINANCE HEALTHCARE
1. National Health Accounts (NHA) is useful in supporting stewardship role and decision-making by both policy makers and stakeholders. There is an increased awareness among policy makers that health sector reforms pursued without adequate knowledge of spending on health or the financing structure of the health sector will not produce the desired results. It therefore becomes imperative that Nigeria as a nation must evolve a National Health Accounts system in line with international standards and practice if we have serious concerns for a sustainable health system. The choice of a cost effective health intervention should be based on good accounting and routinely data and information as improved financial planning and management at all levels will contribute to more rational use of the limited resources.
2. Health Insurance Scheme
The plausible alternative of providing the much needed funds will be through a national social health insurance which funding will be through contributory scheme by the employers and the employees to make it sustainable. It must, however be private-driven with strict government regulation, monitoring and control. Thus, health insurance has three characteristics: prepayment, resource pooling and cost-burden sharing.
It is being touted in some quarters that monetization of healthcare access will be done by some employers but in this poverty-stricken economy such monies will be diverted into other ventures by the beneficiaries and at the end of the day we would have contributed negatively into enhancing the health of the individual or his family.
4. Public and Private Partnerships (PPP)
The creation of an enabling environment for increased private sector and community involvement in service provision and finance is another key factor in healthcare funding and this should be well pursued in Nigeria. The public sector has a crucial role in ensuring equity, that is ensuring access to good quality care for those in greatest need. Commonly those with least capacity to pay. A possible strategy for this is the accreditation of private providers to serve patients who would otherwise depend on public sector facilities through public/private partnership.
5. Equipment Leasing Option
This is an area that we need to explore in this country so that competitive sourcing of finance from various suppliers can help the growth of the health industry. A business can negotiate lower regular payment and there is little risk of retaining obsolete equipment and interest payment on sourced finance may be tax deductible as an operational expense. The business may also negotiate the option of either returning the equipment at the end of the lease period, purchase the leased items at fair market value, or continue to lease equipment on a regular basis.
In conclusion, it is hoped that government will evolve a sound strategy in healthcare financing in Nigeria with a palpable and verifiable reeducation in our disease burden, then health will truly appropriately be wealth in Nigeria as in other advanced economies of the world.