By Chikezie Ogbonna
Health insurance is an important mechanism to prevent financial hardship in the process of accessing health care. Since the launch of Nigeria’s National Health Insurance Scheme (NHIS) in 2005, the nation is still grappling with the level of under representation and poor access to good health care amongst the vast majority in the country.
However, with the increasing cases of preventable deaths and inability of many to access good health care in Enugu, the Catholic Bishop of Enugu Diocese, Most. Rev. Callistus Onaga initiated the idea of a health insurance scheme in 2015 named Ndubisi Health Insurance which is aimed at bridging the gap for many people who find it difficult to sustain the increasing cost of good health care.
His Lordship recently emphasized on the need to embrace health insurance. Obviously concerned with the level of health challenges people are facing currently, which is relatively not unconnected with the high level of death in the country as a result of treatable and preventable health issues.
In this exclusive interview with The Choice Flame, the Director, Ndubisi Health Insurance, Rev. Fr. Benjamin Eze shared with us the idea behind Ndubuisi Health Insurance as well as the many ways it has become a succor to the health needs of the faithful and beyond in Enugu Diocese.
What is the idea behind the establishment of Ndubuisi health Insurance?
The Health-Insurance Scheme came into limelight when Most Rev. Callistus Onaga, the Catholic Bishop of Enugu, having mostly the lay faithful in mind, saw that there is a need for a health insurance scheme for the Diocese. This happened at a time when he came to address the pastoral issue of the Diocese in the year 2015. Having been trained oversees and having knowledge of the civilized world, Bishop Onaga knew that every citizen needs to have their health insured in order to have more quality health.
Personally I have discovered that the rate at which people come to our parish offices for health challenges is very high. Some of these issues can be handled if these people are under insurance. Those people who do have their health insured at a time experience little challenges health-wise and financially, and find it difficult to cope. But the health insurance is a game of number. It is the healthy paying for the sick. This is the whole idea of the health insurance scheme.
There is this idea Igbos usually have, they say “Aku na-esi obi ike”. When you have an assurance that when you have a little health challenge that if you go to a particular place that you will obtain good health care, then it will serve as a motivation and courage to move ahead. Thus, Bishop Calistus Onaga deemed it wise to form an alliance with those who have an idea of health, so that it can alleviate the suffering of the people. In as much as all must die, but some out of ignorance and carelessness have died of certain illnesses which they would have overcome, and had their lives prolonged.
Also, when we look at our own setup in Nigeria, we discover that the Igbo man- the south-easterners, so to say are not the type who care a lot about insurance, not to mention health. You will hear most of them say “How can they use their money to buy sickness?” But to the westerners, insurance is a welcomed idea. That is why they celebrate life insurance/health insurance. They know more about the importance of insurance, unlike our people here. But insurance is something necessary for us to know. It will help us health-wise.
Is it open for only Catholics?
This health insurance scheme is not only for Catholics. Whether catholic or non-catholic, as far as you are a human being in need of health, we attend to you. It is for all because health is for all. I recall for instance the Year of Mercy when Bishop Onaga advised all the parishes in the Diocese to register at least five persons from each parish. I know that in one parish in Udi Deanery, which has five zones, wanted to take the poorest of the poor from each zone. It happened to be that from one zone, the poorest of the poor was not a catholic, but they picked the person as one of the beneficiaries of this scheme. So it has nothing to do with Catholics, but with human beings.
This insurance scheme had been in existence for over five years now.
The health insurance must always have a limitation. As young as we are, as a health insurance establishment, you do not expect us to be able to cover everything. We have what we call Basic or Primary Care Package versus Secondary Care Package. These packages cover lab tests and common illnesses like malaria, also minor surgeries like Hymenia. We do not cover the issue of Tertiary Packages because they cover certain illnesses that we cannot even handle. These are illnesses like Dialysis, Cancer, etc. So the idea is to start from minor cases that are always with us.
How would you access the level at which people have embraced health insurance opportunities in the diocese since its establishment?
In truth, the response of people to the Insurance Scheme is not 100%, but it is not also 0%. People are responding, but like I mentioned earlier, the mindset our people have of it reveals that they do not embrace it very well. Some people have the privilege of having health insurance in their places of work, like many of Civil Servants. But more than half of the people are not Civil servants, but poor people, the retired and peasant farmers, and they need to be captured in this system. Some have no idea what the Health Insurance Scheme is all about. Some have the idea but they do not have what it takes to access it. Some also have bias about the whole concept of Insurance which may be as a result of some events that may have transpired in one area of the country or another. So when the issue of Insurance comes up, they think it is one of those unfortunate incidents that they have heard of. But some people who understand the whole idea are cuing in. We believe in miracles but are not expecting magic that within a short period of time that every Diocesan will just embrace the concept of Health Insurance. Within this period, we went to different Deaneries to bring to the people’s consciousness this idea of the health-insurance. The people are responding, though gradually, but we need do more sensitization.
What are the challenges faced in your operations so far?
The challenge we have is ignorance of the Insurance scheme, on the people’s part. For instance, we had a good catholic philanthropist from Ezeagu who sponsored over 135 people in this scheme yearly. Most times you will find that some people because of their ignorance of the Insurance scheme end up going to the hospital even after the one year sponsorship has expired, and expecting that manna will fall from above. After that year, nobody queued in to register. Thus, ignorance has always been a major issue. For this reason we continuously sensitize them on the importance of the Insurance scheme. Those who knew what it is have known that there are certain issues that they have had that would have cost them over N200000 or N300000 which was solved by the little token that was paid for the insurance.
Then, secondly, some people think that when they are sick they will just go to the hospital and since they registered for health-insurance and did not go to the hospital for a whole year, there is no need to register again. It is just like a palm wine tapper who does not tell his family to prepare hot water for his body to be massaged in case he falls from the tree. But sickness does not notify you when it will come. It does not say if it is coming today or tomorrow or next week, then you begin to prepare for the time of its coming. You may see someone who is healthy today and tomorrow is seriously ill. This is why when we have the knowledge something, we prepare ourselves. Whether you get a hint that you are about to fall ill or not, you can prepare a support for yourself.
What are some of your success stories?
We have many success stories from different quarters. The Bishop made it in such a way that we did not concentrate only in Enugu metropolis because if it becomes a matter for only people in Enugu, then the scheme has failed. But then it addresses the issue of all Diocesans, both in the hinterland and in the city. And this is why we also have the facilities in different Deaneries. We went to different Deaneries like Ezeagu, Udi, Emene, Agbani, Enugu itself, Nkwo-nike, and people have been testifying. People who registered under this scheme and have gone to the hospital are happy that things are working. We cover schools also, like some Catholic schools. One woman thanked me for the scheme, saying that her child has been having incessant malaria and it has been costing them so much. Since the school started this health-insurance scheme and they registered, they have been having a little breathing space. So there are many success stories here and there.
What advice would you give over health insurance in Nigeria?
My advice to people is that health is wealth. The people must know that even the State and Federal government have National Health-Insurance Scheme (NHIS) emphasizing on the issue of health. Even Enugu State is starting what is called Universal Health Coverage (UHC). They want to make sure that people understand the importance of health. And when we become conscious of health and know its importance, then we can reduce to a great level the death rate in our place. When you investigate many of the illnesses in hospitals, you will see many cases of death. Ask many of the doctors there how many cases they have there, they will tell you there are about 30 or so. These are prolonged cases that would have been handled at the primary level that was not treated and so became complicated that you will not even know where to start. Some people are brought half dead and then they will say the individual died in the hospital. But we know that when we are able to harness this idea of health care, then it is easier for people to be going on a regular check up. If anything comes up, it is easier to handle at the primary level before it becomes a complicated issue. So we still need to do sensitization to teach the people. We still need to reach out from the state and primary sector, the community health based, etc.
I know that before one is employed into an office oversees, while filling in one’s particulars; you will also fill in the health-insurance scheme that you are joining. So there is no question of deliberation on whether you want to join or not. But our structure here in Nigeria is not the same. So this is why we still need to campaign, sensitize the people and assist the people. Some people have good will but they do not have the money.
We also need to reach out to some of our good generous Catholics who can also assist, to educate them to invest in the health of the poor. Just like what happened in Ezeagu, someone can insure the health of a group of people, like some parishioners. It must not be for yourself. You may be covered by your place of work or one group or the other, but there are some people who do not have such privilege, as they do not have the money for it. These people need the assistance of generous Christians. So that people can also cue into the Health Insurance Scheme.
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