Juliet Jacob Ochenje
There is no gainsaying the prevailing economic crisis in Nigeria has resulted in many sick individuals bearing the heavy yoke of medical bills.
Unarguably, hundreds of thousands of the population are left impoverished. No thanks to the current economic downturn being witnessed by the citizens. But despite the often-repeated statement, “Nigerians have the right to health”, a large portion of the population cannot access the national or state health insurance schemes.
In its place, hospitals, whether public or private, demand upfront payment from the sick. This has occasioned heavy reliance on out-of-pocket payments. This is a sad narrative of the nation’s health and economic systems. Unfortunately, the situation is sending an ill signal about the country’s state of economy and its population getting poorer.
African Health Report recalls that recently, a reputable global organization gave a damning report on the Nigerian poverty index and said over 90 per cent of the nation’s citizens are living in multidimensional poverty. Indeed, the worsening economic crisis has plunged many more into poverty.
However, as the World Health Organization (WHO) puts it, out-of-pocket payments can make households and individuals incur catastrophic health expenditures and this can aggravate the level of poverty.
Out-of-pocket payments are costs that an individual is responsible for paying that may or may not be reimbursed later.
Oftentimes, out-of-pocket is used to describe an employee’s work-related expenses that the company later reimburses.
Also, it is used to indicate a health insurance policyholder’s non-reimbursable share of medical expenses such as deductibles, copay, and coinsurance.
Sadly, most of the patients who pay out-of-pocket bills are not covered by any insurance schemes.
This is unfortunate because it can cost about N15,000 only to enroll into the scheme for one year, whereas a single episode of ill health can gulp more than that amount depending on the severity. Some sick individuals are deterred from enrolling or accessing care from their healthcare providers because they doubt the quality of care, especially at Primary Health Care (PHC) facilities, and prefer to pay out-of-pocket for trusted alternatives.
Again, this is sad because with the gigantic sum of money so far expended on the PHC agencies and facilities across the country, improved services in the system were expected.
This reliance on individual payments can push households and individuals further into poverty, particularly considering that 70 per cent of Nigerians are living impoverished. Studies have shown that catastrophic health expenditure is prevalent among households, negatively impacting their living standards and overall well-being.
Despite the establishment of a National Health Insurance Scheme in 2006, more than 90 per cent of the population remains uninsured, with only a small percentage covered by either the NHIS or private health insurance.
Additionally, the cost of medication has significantly increased, making it even more challenging for individuals to afford necessary treatments.
This dire situation was illustrated in a social media post where a man collapsed on the road due to lack of an inhaler, only to be rescued by a little schoolgirl who happened to have a spare inhaler on hand.
Speaking with African Health Report (AHR) a patient, Mr. David said “I was at the hospital two days ago for a Malaria test which cost three thousand Naira, but I didn’t with enough money, so I decided to go home and came back today. When the result came out, I was diagnosed with Malaria and Typhoid. The doctor suggested that I commence the treatment immediately, but I couldn’t because of lack of money, I don’t have money for the bill things have been very tough for me and my family that we could barely eat three square meals, so getting the hospital money would be impossible right now. The country is very hard right now the rate of the dollar is very high and so all the commodities are expensive right now. So, the only option I have right now is to opt for self-medication, I will go to a local pharmacy and get some Malaria drugs and I pray that works out well. The doctor said I was supposed to be admitted and placed on drips, but I don’t have money for that right now.
Hear Ovie Samson, in another interview, “I’m an asthmatic patient, and I have had the condition since I was a child. The only way I have been able to control it is through the use of the inhaler and I always make sure I don’t ever run out of it, but lately, things have been very difficult with the hike in the price of everything I find it very challenging to afford my inhaler.
Samson continues; “I work as a waiter in a bar and my salary is just thirty-five thousand Naira from which I have to feed, pay some and many other expenses so at the end of the find it very difficult to get my inhaler.
“These days I go out most times without the inhaler and that is very risky, to be honest. But I don’t have any choice for now. The price of everything has tripled. I just put my hope in God and I pray not to get the attack anytime soon because I don’t know how I’m going to survive it.
Mrs. Oluwatoyin shared her experience with our reporter, stating that she recently gave birth to her second child via Cesarean Section. However, she expressed her concern over the exorbitant bills given to her husband upon their discharge from the hospital. This led her to contemplate the conditions that would exist in a private hospital if a general hospital had such high costs.
Oluwatoyin also highlighted the alarming cost of living in Nigeria at present. The situation has raised some critical questions about what plans the government has to alleviate the suffering faced by Nigerians. Another valid question is whether the government is prepared to mitigate the hardships the populace is going through as it has yet to announce any programme or package towards addressing the situation.
With the suspension of the social investment programme by the government due to the graft indictment of top government officials, more citizens are being pushed into poverty rather than alleviating them out of it.
But with the biting economic problems, the government is urged to take proactive steps to salvage the ugly situation.
