HMCAN Boss: NHIS Needs Technocrats, not Politicians

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Martins Ifijeh

The National Chairman, Health and Managed Care Association of Nigeria (HMCAN), Dr. Tunde Ladele, has called on the federal government to henceforth appoint technocrats to manage the National Health Insurance Scheme (NHIS), rather than use politicians.

He said the scheme has so far not lived up to expectations because those managing it were not familiar with the system and how it operates.

Stating this during a live programme on TVC in Lagos recently, he said the scheme involves a lot of actuaries, statistics, finances, insurance and medicine, hence putting just a doctor or professor to man it was not sufficient.

“There are people that have been practicing health insurance for 15 years, and NHIS is about 10 years old. These categories of people are highly experience in areas of health insurance. They have attended several trainings and conferences, and are technocrats. They are the ones who should man that place for effective operation. I can mention at least 18 people who are very qualified to help run the scheme.”

Noting that the scheme still has a long way to go, Ladele said the association’s recent visit to the House of Representatives, where it was alleged that N351 billion has been misappropriated by Health Management Organisations (HMOs) in 12 years, showed that the needed amount annually for a population of about 170 million people was at least two trillion naira.

He also called on the government to establish a governing council in the National Health Insurance scheme, as well as an ICT platform, if it must curb corruption in the system.

He said corruption is thriving in NHIS because there was no governing council in place to checkmate excesses of those managing the scheme, adding that the establishment of the council, as provided by the Law establishing NHIS, would make it possible for the Executive Secretary of the scheme to be checkmated.

“NHIS Act 35 of 1999 was obsolete and needed reviewing as indicated by the 2004 NHIS amendment Bill which made provision for a Council which is expected to oversee the day-to-day running of the scheme, function as registering HMOs and Healthcare Providers, provide policy guidelines and administration for the scheme, determine after negotiation, capitation and other payments due to healthcare providers by HMOs, among other functions in order to check the excesses of the ES as the sole administrator and sole signatory to the accounts of the scheme.

“Unfortunately we are faced with a situation that was not created by Law in which an ES has become the sole authority to determine who is an HMO or Care Provider and even disburses more than what the Law stipulates, simply because of the gaps created by non-existence of a governing council.

“The situation has become an aberration in which even the excesses of some Health Maintenance Organisations (HMOs) could not be punished because there is no collaboration between the Regulator and the HMO Managers,” he said.