How States Can Drive a Robust Health Insurance Scheme Process

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Monday, July 08, 2019 / 12:00PM / Bukola Akinyele for Proshare WebTV / Header Image Credit: UConn Today - University of Connecticut


Nigeria’s 36 State Governors were recently urged by President Mohammadu Buhari to improve healthcare access in their States and provide better risk protection coverage or insurance.  Mr. Ekerete Ola Gam-Ikon, a management consultant in an interview with Proshare WebTV reporter Bukola Akinyele, explained the critical issues around deepening Health insurance in the country.

Gam-Ikon stated that to drive a robust Health Insurance Scheme,  proper identification, screening of the stakeholders and service providers, especially in terms of their capacity to meet the needs of customers, was required.

The stakeholders in this regard include insurance companies, hospitals, health professionals and other investors in the value chain.

The management consultant stated that it was important to distinguish between health insurance for medical claims which are limited to catering for hospital bills, and broader insurance cover to meet expenses for disabilities, evacuation and death.

He believed that States as key stakeholders in terms of providing health infrastructure, therefore need to address the quality of such infrastructure and the personnel that will give attention to patients.

Gam-Ikon proposed a Public-Private Partnership framework, PPP, to attain efficiency in the management of the process, stressing that the facilities should be in the hands of the private sector.

States, according to him, also need to create Health Security Funds to serve the health insurance programs beyond persons on their payroll.

“If you say every qualified resident should pay a specific amount per month or year to access healthcare, other stakeholders will develop appropriate product offerings to match it,” He said.

Speaking on the challenges facing the National Health Insurance Scheme; Gam-Ikon said that the NHIS be scrapped if the law cannot be overhauled.

“Given what we know today, NHIS is just collecting monies from workers to share amongst selected HMOs. When NHIS started with those HMOs as pilot testing the concept, that is what it was meant to be a pilot but those selected convinced the regulators not to open it up” He noted.

Giving further insight he noted that interested new HMOs were now expected to push their strategies to win new organizations and they competed quite well against the established ones before re-licensing was introduced and some of them were de-licensed leaving their customers exposed and stranded.

He was of the view that conventional insurance companies offering health insurance were more successful than the NHIS model which is why he proposed that governments whether at State or Federal level should focus on health infrastructure through PPP and allow interested insurers with the capacity drive the segment. 

Looking at the current Recapitalization of the Insurance Industry of Nigeria and how it will impact health insurance in the country, Gam-Ikon said recapitalization would enable the insurance companies to explore the rich opportunities for premium generation health insurance.

According to him, “Retail insurance holds the hope for a major transformation of the insurance industry in Nigeria in terms of premium growth and health insurance can be the leader if well managed.”

“With N18b, N10b and N8b for Composite, General and Life insurance companies respectively shareholders and investors would be interested in getting 2-3 times these amounts as annual premium (turn over)and incrementally in subsequent years, so another source of generating income like health insurance would be most welcome,”  he said.

Gam-Ikon also highlighted the fact that only a few insurance companies are offering health insurance, citing the fact insurance firms like  AXA Mansard earn more from their health insurance line than others.

He was optimistic that other insurers would get into the health insurance space as the recapitalization process settles next year.


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Proshare Nigeria Pvt. Ltd.

Proshare Nigeria Pvt. Ltd.
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