The importance of a healthy worker to private and public organizations cannot be overemphasized. A healthy population makes a healthy nation and workforce upon which the realization of corporate objectives of organizations largely depends. However, when health problems occur among workers in their productive years the number of available workers reduces, absenteeism increases while productivity decline. The Global Business Council on HIV/AIDS (2002) reasoned that with increasing absenteeism organizations will experience loss of skills and declining morale which is likely to lower productivity.
It is in view of the above that some employers sometimes establish health scheme for their workers to address their health needs. One of such health package is the National Health Insurance Scheme established by the Federal Government of Nigeria in 2005 as a policy response to the rapid escalating cost of health services and the lack of accessibility to health services by majority of Nigerians despite the National Health Policy (NHP) of 1988. Since the establishment of the scheme four years ago there have been mixed feelings about the impact of the programme on workers.
This study is therefore conducted to find out the perceived impact of the National Health Insurance Scheme (NHIS) among registered staff in Federal Polytechnic, Idah in Kogi State, Nigeria. The issues which constitute the problematique of the study are broadly summarized in four principal research questions as shown below:
(i) What is the scheme all about and the challenges of the programme?
(ii) What is the perceived impact of the scheme on registered workers in terms of morale and job satisfaction?
(iii) Do worker access health services through the scheme and what is the quality of series rendered by health service providers.
(iv) Does the scheme have any effect on health status of workers and their finances?
The remainder of this paper shall seek to answer these questions by way of utilizing primary and secondary data.
NATIONAL HEALTH INSURANCE SCHEME: A LITERATURE REVIEW
The National Health Insurance Scheme (NHIS) was launched in 2005 by the Obasanjo Administration (1999-2007). The idea for a scheme of this nature was conceived in 1962 but was only executed forty three (43) years after because of lack of political will to actualize the dream by successive governments (Falegan, 2008), both military and civilian. Explaining the purpose of the NHIS, Ononokpono (2008), notes that it was established to provide comprehensive health care delivering at reduced (affordable) costs, covering employees of the formal sector, self-employed, rural communities, the poor and the vulnerable groups. The scheme is therefore aimed at solving the problem of inequality in the provision of health services (Ibiwoye and Adeleke, 2007). Health service is for all- both the rich and the poor.
The scheme recognizes the fact that the impact of ill health can take the form of soaring financial cost of illness, low productivity at workplace (Sanusi and Awe, 2009), absenteeism, etc. For instance, in recent years, 500 million work days were lost in Europe due to health related problems (Woolhandler et al, 2003; Colins et al, 2007).
The NHIS was established by Decree 35 of 1999. The Decree provides for the establishment of a Governing Council charged with the responsibility of managing the scheme. The council consists of the following members.
(i) The chairman who is an appointee of the President on the recommendation of the Minister of Health;
(ii) One representative each from the Federal Ministries of Health and Finance;
(iii) One representative from the office of establishment and management services in the office of the secretary to the Government of the Federation;
(iv) One person to represent the Nigerian Employers Consultative Association;
(v) One person to represent the Nigeria Labour Congress (NLC);
(vi) One person to represent the registered health maintenance organizations;
(vii) One person to represent the private health care providers
(viii) Two representatives of public interest; and
(ix) The Executive Secretary of the Scheme who is also the Secretary to the Council
Members of the council are expected to be men of proven integrity, and possessors of relevant high education and knowledge. …