Wetin Nigerians don see for health insurance companies hand

Giyah Ishaku na pesin wey dey enta hospital wella sake of say she dey sick on a regular.

One luck wey she get be say, evri month di company she dey work for dey remove small money from her salary and oda staff, give Health Management Organisations (HMO) make dem keep as insurance.

For Ishaku mind, dis one mean say na HMO suppose settle money for her hospital treatment weneva she sick.

But Ishaku no get good tori about di HMO she bin dey do bizness wit tey tey sake of say dem dey slack well well.

Ishaku tok say di hospitals alias health providers wey her HMO dey like send am and odas go for her company wor-wor for standard.

"Na so so struggle wit HMO to pay for health services I need from health provider," she tok.

Las las wen she change her 'bad' health provider to one wey sweet her belle, di HMO do u-turn wen dem deny say dem give Ishaku permission to change and dem no gree pay her hospital costs.

So na Ishaku settle di money from her own pocket and e reach months before dem settle di kwanta. She say she know good HMOs dey but dem scarce and e hard to find.

Emma na pesin wey no dey enta health provider anyhow but dis year she get one car accident.

Even though she no too wunjure, she bin get post traumatic stress disorder (PTSD) wey dey make am depressed.

Wen she cari her leg go health provider, dem no gree give her private ward even though na wetin beta pass for her condition.

Dem say her insurance no cover dat wan. Wen she complain say she no enta hospital for almost one year so dem suppose try for her, dem no gree.

Why HMO?

"Make all Nigerians live full and beta life," na one of di policy of Nigeria goment.

Dis na why dem introduce di National Health Insurance Scheme (NHIS) for 2014 so dat all Nigerians go get cheap healthcare wey dem go contribute, through prepaid system so wen dem need healthcare dem no go shake bodi.

Goment dey comot small percentage for di salary of civil servants dem, while companies go remove from dia staff go give Health Management Organisations (HMO).

HMO na company wey register wit NHIS to act as middleman or insurer between dia clients (enrolees) and hospitals (health providers).

Na HMO dey push di agenda of di NHIS to provide quality and good health care services to pipo wey dey contribute to di program while NHIS na di referee.

''Health insurance na risk''

BBC Pidgin speak wit one Abuja based doctor wey dey work wit HMO but im no gree make we tok im name for hia.

Doctor tok say some customers a.k.a enrolees wey dey use HMOs no understand say insurance bizness any wia for world, na big risk.

Doctor say, ''wetin some enrolees dey expect pass di money dem dey contribute as insurance''.

''If we collect N1,000 from one company to treat ten pipo but las las na N2,000 we spend, we go pay N2,000 sake of say we don sign contract'', na so doctor tok.

Also if HMOs begin pay for tins wey no dey inside contract like di case of Emma, na evri bodi go follow her style bring dia own case wey no dey contract come and HMOs go come get big palava.

At di same time dis bizness suppose make profit for shareholders wey don invest inside dis bizness.

Doctor say out of di more than 160 million pipo for Nigeria wey fit register wit HMOs to give dem insurance, na around 5 million pipo get HMO cover so di market no too big like dat.

Doctor gree say like any oda bizness for world, bad HMOs dey but good ones also dey wey dey follow di rules also dey.

''Reforms wey NHIS dey bring come dey change HMOs for beta''

Dr Chinemerem Magnus Ogaraku na di former chairman of di Nigeria Medical Association (NMA) branch for Kogi state, north central Nigeria.

Oga Ogaraku say as health provider and enrolee for National Health Insurance Scheme (NHIS) im fit tok say tins dey improve.

One way be say health providers now dey collect monthly 'salary' from HMOs instead of evri three months like before.

Anoda reform na accreditation of HMOs, wey be tests to check weda dem qualify to get license from NHIS to practise.

HMOs must show say dem get enough capital, staff and even good office before NHIS go gree allow dem work.

For April dis year, NHIS comot 23 out of di 57 HMOs wey dey operate for Nigeria because dem no meet di minimum standard.

Ogaraku tok say dis accreditation wey di Executive Secretary Usman Yusuf for NHIS introduce dey very important especially for health mata, wey be life and death.

As e be so, all HMOs suppose renew dia accreditation evri two years.

''Dis reforms go make health insurance sector more open and transparent so more pipo outside go no wetin den happun inside,'' na so Ogaraku tok las las.