Universal Health 2030 Solving Complex Health System Problems
November 2015 ThisDay; Many Nigerians are not buying into health insurance plans due to lack of awareness of the benefits they stand to get. The Chief Executive Officer, Axa Mansard Health Ltd, Mr. Tope Adeniyi, in an interview with Martins Ifijeh, urged Nigerians to take advantage of the various health insurance plans as they have been proven to improve access to healthcare and in turn save lives Adeniyi
Why don’t most Nigerians access health insurance?
The major reason is lack of awareness. Most people are not aware that with health insurance, you don’t have to pay out-of-pocket to access healthcare. We are aware every Nigerian wants to live healthy, so certainly, all Nigerians would like health insurance cover that would prevent them from paying out-of-pocket when ill health arise, but the problem is that there is presently low awareness on it, coupled with lack of seamlessness of service delivery, and that is what Axa Mansard Health Limited (AMHL) has come to address.
We are still far from enjoying health insurance services in Nigeria. Only 8.5 million people are covered by health insurance in the country out of the over 180 million Nigerians. That is only about five per cent of Nigerians.
What is the focus of AMHL in addressing healthcare issues in the country?
AMHL is a subsidiary of Axa Mansard Group, an entity of Axa, which is the biggest insurance group in the world, with over 150,000 staff and 103 million clients. Axa acquired Mansard in December last year, so as to afford customers a bigger and stronger platform to provide quality healthcare services in Nigeria.
AMHL focuses on providing domestic and international health insurance cover. Even while employees are out of the country for trainings, vacations, seminars, among others, our services cover them. We believe it is high time Nigerians begin to focus on the major things that really matter, one of which is health.
How does the health insurance work?
Health insurance is available for corporate groups, families, other groups of persons, as well as individuals. For AMHL, employers of labour could buy insurance as a group for the benefit of their staff. Families and individuals can as well have access to the service through all our distribution channels, including online and our branch offices across the nation.
How should Nigerians know that health insurance is the best way to go?
Awareness constantly has to go with proof, people want to see what the insurance is all about. On our part, we try to create fora to discuss health insurance, we talk about it on radio, provide HR conference just to make sure people do not have to pay out-of-pocket for their healthcare because it can be very detrimental to their financial freedom. Ill health comes suddenly, and one might not be financially ready to tackle it when it comes, so the best way to tackle such is to prepare for it.
How affordable is a health plan?
It is very affordable. With less than N200,000, a family’s healthcare can be covered for a whole year, that is less than N20,000 a month for a whole family; and this covers for all the basic health needs.
How would poor Nigerians benefit from health insurance cover?
There are different products that can fit people’s lifestyle and financial strength. Some are small, which can fit into the low income class. However, even the so called poor, spend more money on recharge card than what it can cost to have a health insurance cover. Also, sometimes the cost they incur when real cases of health issues occur, is far higher than the cost of health cover.
So what we try to do is to let Nigerians know they are not paying something so outrageous when they see it on the long run, because with this arrangement, they would have succeeded in protecting their selves from unnecessary spending or financial waste.
Health insurance is very important because it helps to detect health conditions on time, and that prevents one from entering into chronic situations that can be very life threatening. In essence, health insurance spurs people to want to keep their health in check.
Even as we have products for the low income class, there are also products for the working class and high income earners, yet these products are not so expensive, they are affordable.
Who are those qualified to access insurance service?
We have two kinds of people who are qualified to access this service. The first are people who are already in a group; that is companies, small and medium enterprises and families. The idea is that when we take small money from everybody to cater for the few who are ill, or will eventually get ill, healthcare will be better positioned that way. The principle of insurance is to pull resources together so we can take care of those who need it.
The second category is the individual. Ideally we expect to see healthy individuals, but if the person is sick, we try to do analysis on the current risk of the person and then we will be able to tell the person which premium he or she has to be on, because there is an existing risk that has to be handled.
The truth is if only sick people access our services, that will not be very equitable to our pool. Insurance is not necessarily an immediate consumption of benefits but it’s for the future. So once someone comes who already has a condition, we’ll then decide whether we are going to place a premium on such service or place a moratorium on it.
What are the various services offered by AMHL?
Our products cover outpatient services, hospitalisation, minor and major surgeries. We cover almost all surgeries. There may be only a few surgeries that are not covered.
Is there a role the government can play for persons with pre-existing condition, or poor Nigerians who would like to access health insurance?
On this, we need government intervention for pregnant women, the aged, children, then poor people, who cannot afford to buy into any health insurance plan, despite the fact that they are vulnerable.
There should be legislation on health insurance, whereby everyone working, would have to pay something into a pool. The pool will be there to take care of everybody and even reserve a portion for the vulnerable. The pool should be able to take care of people who have been profiled with no capability on their own to have health insurance.
Eventually, everyone should have health insurance from the government funded part, as well as what is coming out from the pool, so that we can have universal health coverage in the country. There is also a role for international organisations like donor agencies that focus on supporting developing countries. Rather than give money to institutions, they can fund health insurance for the citizens, especially the vulnerable groups in the society.
Can government intervention bridge the awareness gap on health insurance?
It shouldn’t be restricted to the government alone, both the public and private sectors, as well as the media can drive the awareness to every nook and cranny of the country. Newspapers can have columns dedicated to its awareness. Radio and television stations can make it a priority to sensitise Nigerians on the need to access health insurance for their benefit.
