Why NHIS does not cover some ailments – Official

The South-West Coordinator of the National Health Insurance Scheme, Mr. Taiye Adeleye, has said that the scheme does not provide treatment for patients needing renal dialysis, organ transplants, heart surgery and other ailments on its exclusion list because they are very expensive to manage.

Adeleye said this in Ado-Ekiti, Ekiti State on Friday at a workshop for NHIS beneficiaries, hospitals and other stakeholders in the scheme. He, however, explained that by special arrangements, beneficiaries of the scheme suffering from any of the ailments on the special list could be treated by NHIS-approved hospitals. The coordinator said that although the scheme covered the treatment of opportunistic infections for HIV-positive NHIS enrollees, the provision of anti retroviral drugs was excluded from the list because an agency of the government had already been saddled with that responsibility. According to Adeleye, “Any ailment not on the exclusion list of the NHIS is covered. Your health care providers have not option than to treat you.” Adeleye, who is a pharmacist, said Nigeria ’s health indices were among the worst in the world. He, however, assured that the NHIS was poised to reverse this. Adeleye said, “Enrollees are encouraged to complain to us about any unsatisfactory service offered them by their health care providers. If any hospital is found wanting by the NHIS, we will sanction such a hospital. “We can withdraw all our enrollees from any hospital to sanction it. “That is a loss of revenue and no hospital wants that. We have in the past withdrawn our enrollees from two hospitals as a way of implementing the sanction.” He said about six million Nigerians were already benefitting from the scheme, adding that it had provided access to quality health care for poor Nigerians. He stated that the beneficiaries were mainly Federal Government workers and members of their families. But he lamented that only two states had signified intention to enrol their workers in the scheme.

Punch Newspapers