Initially, there were daunting issues, and the reason is simple. We are not used to a system where we contribute ahead of when we will need the services. It was a new thing to us, and we needed a lot of patience to be able to accommodate all the problems that arose when we commenced. With time people got a better understanding of the operations, especially the operators, the healthcare providers, who are in our network, got a better understanding, better ways of utilising the funds that are paid to them. So, things started smoothening out. The few issues we have now are complaints of scarcity of drugs. That is when the enrollees go to the hospitals for treatment; drugs are not adequately given to them. These are intermittent complaints we encounter, and as a result, we hold meetings to strategise on how to perfect the scheme. There are also issues of pricing, that anytime we meet, it comes up, we come back to the office to look at reviewing the pricing and all of those things. So, it is a work in progress. We cannot say we are hundred percent done yet.
In most of the thematic areas that we are looking at, the extent of enrollment; we are supposed to cover the whole of Bayelsa State, but now, we have covered only the civil servants, and a few private sector organisations, and a few private people. So, we are not there yet, in that respect.
With regard to caregiving too, because of these complaints, they may not be things that may be completely ironed out in a flash. Consequently, efforts are geared at ensuring that these hitches are reduced to their barest minimum.
We were told that the scheme covers major surgeries as well. Have you carried out such services?
The scheme is very robust, in fact, if you look at our scheme, it is almost like the fallout of the National Health Insurance Scheme, because that was the foundation upon which we built. All those mistakes that they were able to identify as they were operating, at our level, we now have to put modalities to overcome those things, and then a few of the diseases that they did not consider when they were setting up their scheme, we were able to bring them into our scheme. We do major surgeries, myomectomy, caesarian section, prostatectomy for the elderly, eye care, cataracts extraction, or any sort of eye surgery, including dental care, knee replacement. We have bought pastelis for people with diabetes, and paid for amputation for patients. We have done surgeries for multiple pregnancies and have taken care of preterm babies. Imagine someone giving birth to four kids, and all of them come as preterm. We have taken care of them, and those are very expensive medical cases, where ordinarily individuals cannot handle them at their levels. With respect to this type of medical care, the oxygen required for each of them is about N300,000. So, for each month, one would have to pay nothing less than N900,000. But since the patient is an enrollee of the scheme, the scheme foots the bill. So, at the end of the day, each of the babies may cost about N500,000, just for their preterm care, and the scheme is there to take care of all expenditure. And we have done this for several patients.
Do these people who undergo these surgeries and all others you have mentioned pay extra money?
Well, when you come into the insurance scheme, there are some of the things we call, co-payment. We introduce co-payment to certain things to curb abuse and misuse. It would also have been for drugs, but we said, okay, for the fact that we are just starting, let us leave out co-payment for drugs. There are certain cases you may be required to pay a little sum while BHIS pays the balance. Like, if you want to do a CT scan, if you want to do MAC imaging which we call Magnetic Resonance Imaging (MRI), etc., the patient pays 50 percent, and BHIS pays the remaining 50 percent. Apart from that, if it is surgeries and other medical treatments, BHIS bears full responsibility to foot the bills. Those are few things that we do not take 100 percent of the cases, and then some congenital diseases. If you give birth to children that come with congenital problems, we only do the diagnosis, we do not go into the day-to-day treatment of the children.
Apart from that, all other care is borne by the scheme. Which other services does the scheme handle?
Medical practice spreads into diverse specialisations. There is pediatrics; you need services for internal medicines, where we have all sorts of cases of diabetes, hypertension, heart failure, renal failure, and neurology.
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