Health Expert Urges Stricter Monitoring of Facilities to Eliminate Discrimination, Others

Gbenga Sodeinde in Ado Ekiti 

A medical expert and the Chief Executive Officer, Donolush Solutions Limited, Dr Tunde Olujobi, has called for stricter monitoring of healthcare facilities to eliminate discrimination against Health Maintenance Organisation (HMO) patients for virile health insurance in the country.

Olujobi, a former board member Ekiti State Primary Healthcare Development Agency, who said that health insurance policy in Nigeria still faces challenges despite efforts, urged concerned authorities to ensure that HMOs provide fair compensation to healthcare providers.

The former General Manager, Quality Assurance and Medical Services, Premier Medicaid International (HMO), spoke in a chat with THISDAY in Ado Ekiti, the Ekiti State capital, weekend. 

He called on policy makers “to prioritize healthcare reform to ensure that health insurance becomes a genuine financial buffer and to also deliver on the promise of accessible, available, acceptable and ultimately affordable quality healthcare for all Nigerians”.

Olujobi lamented that discrimination, economic doldrums, delayed reimbursement and underfunded health facilities have contributed largely to the near collapse of the health insurance scheme in Nigeria.

The medical expert regretted that “while health insurance in Nigeria is meant to provide a safety net, yet many enrollees feel left in the lurch”, adding that while having patients who  are supposed to  be covered through the illusion of financial security, the reality often falls short.

He said: “Many HMO patients report discrimination in both public and private facilities. I was privileged to have once served as a general manager in charge of Quality Assurance and Medical services in one of the HMOs.

“We had a large number enrollees’ base spread across the country, with more than a thousand healthcare providers. We got reports that some hospitals prioritize patients paying out of pocket over those covered by HMOs, leading to delayed treatments, limited access to specialist care, dispensing of unbranded drugs and sometimes outright denial of services.” 

Olujobi lamented that the fallout was further exacerbated by Nigeria’s ongoing economic challenges, affecting both healthcare providers and patients. 

According to him, “Service providers face rising costs, from purchasing medical supplies to paying staff, yet the reimbursement from HMOs often fails to keep pace. 

“This shortfall places immense pressure on service providers, resulting in restricted services or increased co-payment charges from the enrollees.”

He lamented that at some time, patients already struggling with inflation, feel the burden as they experience delays or substandard care, making them “insured but not Insured”.

“To address this regulatory oversight, concerned authorities are to ensure that HMOs provide fair compensation to healthcare providers.  There is need for stricter monitoring of healthcare facilities to eliminate discrimination against HMO patients,” he stated.