By Bukar Mohammed
For many Nigerians, the National Health Insurance Scheme (NHIS) is supposed to be a lifeline—a way to ensure access to essential healthcare services without the financial burden that can so often accompany medical expenses. However, for Bukar Mohammed, a young professional, and many others like him, the scheme has instead become a source of frustration, leaving beneficiaries without the promised access to basic healthcare services.
The National Health Insurance Scheme (NHIS), now rebranded as the National Health Insurance Authority (NHIA), was supposed to provide relief to millions of Nigerians seeking affordable healthcare. The NHIA bill, passed to replace the NHIS, was meant to enhance efficiency, transparency, and accountability. However, despite these legislative reforms, the system continues to falter, and many Nigerians are left with little access to quality healthcare.
Two years ago, Bukar approached the NHIS with a simple request: to update his health insurance account to reflect his current wife as the rightful beneficiary. Despite the clear need, his efforts were met with red tape, unresponsiveness, and ongoing delays. To this day, Bukar’s wife is still not listed as a beneficiary, even though his organization has consistently remitted health insurance payments on their behalf. This bureaucratic failure has left Bukar disillusioned with the system, especially as he prepares to welcome his second child into an economy marked by high inflation, increasing energy costs, and heavy tax burdens.
As Bukar’s story highlights, the NHIS is failing those it was meant to serve. Rather than providing critical healthcare access, the scheme has been bogged down by inefficiencies, questionable service standards, and an apparent lack of accountability. This situation is not only unjust but unsustainable for the countless Nigerians who rely on the scheme for healthcare.
A System Mired in Inefficiency and Poor Service
When beneficiaries like Bukar do manage to access NHIS-covered healthcare facilities, they often face further disappointments. Patients regularly report being dispensed unbranded or generic drugs of questionable efficacy, a practice that raises questions about the quality of care under NHIS coverage. Moreover, there are frequent reports of critical drugs being unavailable, forcing patients to purchase necessary medications out-of-pocket. The irony is painful—those paying into the scheme must spend their own limited funds on medicines that the NHIS was supposed to cover.
In addition to these issues, NHIS coverage often excludes essential health services, leaving enrollees without the basic care they were promised. This lack of comprehensive coverage forces people to either pay for private healthcare or go without defeating the scheme’s purpose entirely.
A Call for Comprehensive Reform
The failings of the NHIS are not merely administrative hiccups; they are a profound betrayal of the trust placed in the institution by the Nigerian people. Health insurance is about more than just financial coverage—it is about ensuring that citizens can access quality healthcare when they need it most. When a government health scheme consistently falls short of this standard, it loses legitimacy.
Bukar and other affected citizens are calling on the federal government to step in and take decisive action. First, there must be a complete overhaul of NHIS management. A strong signal needs to be sent that inefficiency, neglect, and lack of accountability will not be tolerated, especially within an agency tasked with protecting public health. Executives and decision-makers who have presided over the current disarray should be replaced by capable leaders with a proven commitment to efficiency and service delivery.
In addition, the scheme itself needs to be restructured to address the systemic issues that are currently eroding its effectiveness. There must be a renewed focus on transparency, improved communication with beneficiaries, and rigorous oversight of healthcare providers to ensure they are delivering high-quality care under NHIS coverage.
The Way Forward
Healthcare is a fundamental right, and a national health insurance scheme should be a cornerstone of social welfare. Unfortunately, for people like Bukar, the NHIS has turned into an expensive, inefficient bureaucracy that fails to meet its obligations. In these challenging economic times, Nigerians can not afford to pay into a scheme that does not deliver on its promises. It is time for the federal government to address these long-standing issues with a comprehensive, transparent reform of the NHIS.
Without bold action, the scheme will continue to betray its mission, leaving countless Nigerians without the healthcare security they deserve.This experience, unfortunately, is not unique but indicative of systemic administrative failures within the NHIA.
It is believed that this matter warrants urgent attention from the National Assembly, SA to the President – Hadiza Bala, particularly to trigger an investigation into the NHIA’s administrative lapses. Additionally, We urge the executive branch to consider a legislative amendment that includes provisions for compensation for victims of such administrative deficiencies, empowering beneficiaries to hold the NHIA accountable.
Bukar Mohammed is a public analyst and commentator based in Kano