Browsing by Author "Gana, Daniel S."

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    The National Health Insurance Scheme: Problems and Prospects
    (National Institute Kuru, 2001-11-30) Gana, Daniel S.
    Health sector reform is on the agenda of the government in Nigeria, as in other developing countries and transitional economiesof the world. This is because health care systems of such countries are characterised by problems of inequitable access, unsatisfactory quality, technical and allocative inefficiencies, revenue shortfalls, escalating costs and increasing demands from the fast growing population with increased demand for social services. Moreover, it is serviced by poorly motivated health personnel. The need to reform the sector informed the establishment of the National Health Insurance Scheme (NHIS). The recognition of the age-long tradition of risk sharing amongst Nigerians, the will for community self-help and solidarity amongst the rural communities have been exploited in the design of the Scheme. The essay reviews the various models of health insurance as practised in other countries like Chile, Tanzania, South Africa, United Kingdom and United States of America. The comparative study shows that the Nigerian model was best suited for the country. Though Act 35 of 1999 that established the NHIS is presently before the National Assembly undergoing amendments, it is the view of this essay that the Scheme be adopted immediately while amendments be made as the Scheme is put to test. Social Health Insurance is based on the principles of "solidarity" and equity. When the risk of falling ill and resources are pooled among a large population, the large resources made available will provide sufficient funds to take care of each member in need of care at anytime. This enhances the security of each individual in the group. There is cross-subsidy, and this is the essence of solidarity. Furthermore, while the NHIS will supervise the Scheme, the Health Maintenance Organisations (HMOs) that are limited liability companies will run the Scheme. That in essence is liberalising the health sector.