10 disadvantages of National health insurance Scheme (NHIS)….

The exact topic of this article first appeared on www.nimedhealth.com.ng

This article does not in anyway intended to discourage you from joining the NHIS program or stop using your NHIS for your basic health needs, no, not at all. It is important we highlight these problems for better service delivery from the National Health Insurance Scheme.

As a doctor that have access to at least 100 patients per week, I think it is important for me to highlight all the difficulties my patient face daily in trying to use the NHIS to finance or pay for their medical bills.

I am here to talk about the 10 disadvantages of using the NHIS in this article.

10 Disadvantages of National Health Insurance Scheme (NHIS)

1. Too much bottlenecks

The stress and hassles that my patients have to go through to get medical procedures and surgeries approved by NHIS is terrible…Sometimes you will have to to go to different offices to get approval for drugs, procedures , surgeries and investigation…it wears out the patient and even the doctor who will have to do loads of paper work to help the patient…

2. Not suitable for emergency

If you have a medical emergency that will will require urgent medical attention or intervention, be rest assured that NHIS will fail you because of the long haul of processes and bureaucracy to get approval for treatment. Emergency drugs like normal saline, analgesia and even approval for emergency surgeries may take hours or even days to be procured via NHIS…

So, I usually tell my patients to bypass their NHIS to get medications or have procedures done on emergency (from out-of-pocket) to save life first until patient is stable enough for the rigorous process.

3. NHIS does not cover most drugs

It is no longer news that NHIS covers only basic (unbranded drugs) and not branded ones. Most drugs in pharmacy are not covered by NHIS and patients on NHIS end up paying out of pocket to get them. Shocking is the fact the NHIS do not cover most antibiotics, painkillers and anti-malarials. Surprising right?

10 disadvantages of National health insurance Scheme
10 disadvantages of National health insurance Scheme and more

4. NHIS does little for patients with Chronic kidney diseases

Patients with kidney failure that will require dialysis are only covered by NHIS for just 6 sections. That means persons with renal problems will pay out of pocket for the greater part of their treatment you know. Nephrologists have on several occasions called on the federal government to look into the poor services NHIS programs offers patients with kidney diseases….here is a link.

5. You don’t really get the best with NHIS

Have you ever visited a hospital that offers health services to NHIS clients? If you have, you will realize that you don’t get the best drugs and many of the investigations are not covered. You will have to also make do with the unbranded and many a times substandard drugs that they have to offer.

On many occasions, the NHIS staff will tell the doctors to make sure they prescribe drugs that NHIS can afford, the doctors have no option other than to prescribe what is available or out of their benevolence, tell their patients to go outside to get their drugs out of pocket.

6. NHIS hates cancer and wants nothing to do with it

As far as NHIS is concerned, cancer patients are on their own and will never fund cancer treatment….NHIS does not even cover basic cancer drugs , surgery, chemotherapy or radiotherapy. Cancer patients get drained of funds trying to get a cure for cancer with no coverage from NHIS. IT IS A SAD ONE.

7. Annoying NHIS staff

The poor attitude of NHIS staff even makes it harder registering on the scheme. The reports of my patients about the unprofessional behavior of NHIS staff leave much to be desired. The hassles, long queues, and talk down many NHIS staff make patients go through is quite disheartening…

8. Corruption

Of course there is so much corruption in NHIS and this affect their quality of service delivery to patients. With, corruption and embezzlement of funds, their will be lesser amount of money available to take care of patients health needs so, they cut corners.

9. NHIS “spoils” patients

Patients on NHIS become too entitled that they become unwilling to pay out of pockets for certain drugs, investigations or surgeries that are clearly and reasonably not covered by health insurance.

For example, patients that desire cosmetic surgeries will require NHIS to cover it…same way as patients wanting NHIS to cover sophisticated investigation like MRI, PET scan and angiography. This becomes a problem to the doctor who treats patients that put all their hope on NHIS funding.

10. NHIS does not cover our aged parents that require regular medical checkup

Nigeria and indeed Africa, run an extended family system remember. Now, NHIS only covers the employee, a spouse (wife or husband) and four (4) biological children below the age of 18 years. You already see the constraints here. NHIS does not cover your parents which you will like to be on the scheme or your children when they are above 18…NHIS needs to do more on this regards ….expand their coverage.

Please tell me your experiences with NHIS in the comments section.

CAVEAT: A country without a program aimed at making health affordable and accessible is a disaster in the making. No country has a perfect or a near perfect health insurance scheme, not even Europe. NHIS genuinely aims to bridge that gap and cover that need, but they need to do more in expanding their coverage both in terms of enrolling more people in the scheme and covering more medical procedures, tests and drugs.

Dr Udomoh ESHEMOKHA wrote this.


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