By: Joy Odor/Kaduna
The Bill seeking to establish Kaduna State Contributory Health Management Authority has been presented to the Kaduna State House of Assembly by the Concerned Civil Society Organizations (CSOs) Kaduna State.
The critical observations and recommendations memorandum was presented by the State Chairman, Health Reform Foundation Nigeria, Mallam Lawal Abubakar on behalf of the CSOs to the Chairman, House Committee on Health, Dr. Isaac Zainkhai in Kaduna on Thursday.
According to the CSO’s, the Bill wanted the age of vulnerable children to be raised from under-five to 18 years while accident and rape victims not captured in the bill should be included and treated as vulnerable.
They were of the opinion that many accident victims die in Nigeria because they were brought to hospitals unconscious and do not have cash to settle their hospital bills.
the CSO’s suggested that the Bill should be made compulsory to ensure pooling of resources and its redistribution from the rich to the poor, the healthy to the sick and from the gainfully employed to the unemployed.
And for this reason, the CSOs recommend an increase in equity contribution by the government in its annual budget on behalf of the vulnerable persons from 1% to at least 2%.
“The vulnerable persons were well captured by the interpretation in Section 3 of the bill, which stated that “Vulnerable persons” “include pregnant women, children under 5 years of age, the aged, mentally challenged, disabled, poor and others persons with disabilities as may be recognized by the Authority.”
“We recommended that “Children under 5 years of age” should be replaced with “children under 18 years of age”, in the interpretation of vulnerable persons. “Accident and rape victims”, should be included in the interpretation of vulnerable persons”.
Similarly, the CSOs also observed that Section 17(2b) of the Bill made provision of “equity contribution of not less than 1 % per annum of the Consolidated Revenue of the State on behalf of vulnerable persons” is among the source of funding the contributory health fund, which is well acknowledged and appreciated.
In view of the above, the CSOs stated that achieve universal coverage, especially to the vulnerable persons, with affordable and quality health care services, “we suggest that a bigger and additional pool of resources is needed by the Authority to manage the scheme, which are as follows: The “equity contribution of not less than 1% per annum of the Consolidated Revenue of the State on behalf of vulnerable persons” should be increased to “not less than 2%”; a 2.5% contributory health management levy should be added to VAT.
On the Third Party Administrators (TPAs), the Concerned CSOs stated that “it is clear that the bill expects collaboration between the Authority as a regulator and TPAs as the purchaser of the health services from the actual health care providers in health facilities.
“This was in tandem with what the National Health Insurance Scheme (NHIS) had been using in managing its scheme. However, based on the poor coverage of less than 5% of Nigerians by the NHIS since its establishment, the Centre for Social Justice (CSJ) has reviewed the provisions of the NHIS and its implementation over the years, and identified specific challenges on the use of Health Management Organizations (HMOs).
“It is therefore recommended that health care facilities registered in section 25 of the bill should replace the TPAs, hence, all the functions of the TPAs specified in section 29 of the bill should be made to be the functions of the accredited health care facilities.
Receiving the Bill, the Chairman, House Committee on Health Dr. Zainkhai promised to study the Memo with other committee members, and urged CSOs to always take interest and participate in the legislative process.
The Chairman, House Committee on Health however, commended the CSOs for their observations and recommendations which will guide the House in the cause of deliberations on the proposed Health Insurance Bill.
“I appreciated the role of CSOs in supporting the Assembly in its work, and the points raised by the CSOs are key in moving forward.