The National Health Insurance Scheme (NHIS) is a corporate body established under Act 35 of 1999 by the Federal Government of Nigeria to improve the health of all Nigerians at an affordable cost. Given the general poor health state of the nation's health services and excessive dependence and pressure on Government owned health facilities, with the dwindling funding of health care of rising cost, the scheme is designed to facilitate fair financing risk protection and cost-burden sharing for people against high cost of health care through institution of process aid mechanism, prior to their falling ill. This is in addition to the provision of regulatory oversight oh health maintenance organization (HMOs) and health care providers(HCPs).
However in practice, an efficient and equitable health financing system is only achievable when there are deliberately efforts to define we'll articulated legal framework that only provides a strong and institutionalized regulatory capacity but also makes it possible for adequate health resource mobilization. One of the recommendations of the of the newly amended Act is to make participation in the NHIS compulsory. But in arguing for for a mandatory participation, executive secretary of the NHIS, Malam Waziri, Dogo-Mohammed notes " Under a revamped health care system, ever employed Nigerian Would be required to buy an insurance health cover and the Federal Government would provide subsidies for the poor and indigent". He argues that the Act establishing the NHIS make our social insurance optional. "Our experience shows that a number of important participants are not participating".
The only way we can make it Mandatory is to amend the Act, NHIS is going to be made compulsory. The name of the scheme will change and we realised that the Act gave the scheme a very difficult name but by the time the Act is dobe with, we'll have a better Act that will address most of tgw peculiarities of NHIS. The present Act of 35, 1999 that established NHIS is long overdue forreview as it dis not address key issues in the scheme: these are failures, to define the coverage population, failure to outline funding mechanism for the under privileged failures to make the scheme compulsory and failure to collecting finds from the informal sector.
Consequently, the informal sector which is the largat uncovered population has been integrated into the scheme. There is immense private sector participation in the scheme. All the HMOs that are privately owned play a dominant role in the delivery of care because of the dominance presence of the specialist in the hospital.
The main objectives of the Scheme as set out in the Act 35 of 1999 are:
To ensure that every Nigerian has access to good healthcare services.
To protect families from financial hardships of high medical bills.
To limit the rise in the cost of healthcare services.
To ensure equitable distribution of health care delivery services within the scheme.
To ensure efficiency in health care services.
To improve and harness private sector participation on the provision of health care services.
To ensure the equitable distribution of health Facilities within the federation.
To ensure appropriate patronage of all levels of health care.
To ensure the availability of funds to the health sector for improved services.