CHAPTER ONE
INTRODUCTION
Background of the study
Health care insurance plan has been a growing concern to many
developing countries in recent times. Given that health insurance is
designed to cover formal and informal sectors, rural and urban
locations, low and high income earners, it becomes critical as well as a
challenge for developing countries as they seek to design, operate and
manage effective health insurance system that benefit all citizens.
According to Mossialos et al. (2002) there are basically five forms of
health financing available to any country. These include taxation;
social health insurance; voluntary and private insurance; out-of-pocket
or cash-and-carry; and donations. It is said that identifying a
sustainable source of financing health care in the world has indeed
become a major issue for discussion across the world’s powerful
institutions and stakeholders. The United Nation and other groupings
andorgans representing the continents of the world are developing
strategies for sustainable health care insurance plan. According to the
World Health Organization (WHO), supporting adequate, sustainable,
equitable and effective health financing to improve health outcomes is
one of the most important goals of the World Health Organization. The
Executive Board of WHO and the fifty-eight World Health Assembly have
discussed and provided strategic directions on sustainable health
financing, universal coverage and social health insurance.
Health insurance is
insurance against the risk of incurring
medical expenses among individuals. By estimating the overall risk of
health care and
health system expenses,
among a targeted group, an insurer can develop a routine finance
structure, such as a monthly premium or payroll tax, to ensure that
money is available to pay for the health care benefits specified in the
insurance agreement. The benefit is administered by a central
organization such as a government agency, private business, or
not-for-profit entity. According to the
Health Insurance Association of America,
health insurance is defined as "coverage that provides for the
payments of benefits as a result of sickness or injury. Includes
insurance for losses from accident, medical expense, disability, or
accidental death and dismemberment"
1.2 Statement of the problem
Health care insurance has become a global challenge to all
countries and all persons. The ability of national governments to
provide funding for health care and to sustain the funding is a huge
responsibility, Nigeria is no exception. New and innovative ways are
being developed by Governments all over the world to ensure that basic
health care is available to all at affordable prices and is equitable.
In line of the above, the study was conducted to find out the impact of
health care insurance plan in Nigeria.
1.3 Objectives of the study
1. To determine the impact of health care insurance plan have on Nigerians.
2. To identify the relationship between health care and insurance plan.
1.4 Research questions
1. What impact does health care insurance plan have on Nigerians?
2. Is there a relationship between health care and insurance plan?
1.5 Research hypotheses
Ho: There is no significant impact of health care insurance plans in Nigeria.
Hi: There is significant impact of health care insurance plans in Nigeria.
Ho: There is no relationship between health care and insurance plan.
Hi: There is a relationship between health care and insurance plan.
1.6 Significance of the study
Health insurance is a health insurance risk hedged against the
probability that if and when someone unexpectedly becomes sick,
requires expensive treatments, or is at the mercy of a chronic
condition that requires long-term care they will not fall into dire
financial straits.It is a benefit provided through a government agency, private business, or non-profit organization.
High-quality health care affects health and wellness. A health
insurance policy is a contract between an insurance company and a
policy holder intended to safeguard against high and unexpected health
care costs. Although policy-holders pay a monthly premium, co-payments,
co-insurance, and deductibles, it is expected that the total is far
less than that required if paid fully out-of-pocket.
Coverage from a health insurance policy or a public health program
can greatly relieve the financial burden of health care expenses.
Those who are uninsured or underinsured can experience financial strain
and require assistance from alternative funding sources which may not
be available at that time. This study will be educative as it will
inform people about the enormous benefit of health care insurance plan
and it will also be a reference point for researchers.
1.7 Scope of the study
The study focuses on the impact of health care insurance plans in
Nigeria using Lagos University Teaching Hospital (LUTH) in Idi-Araba,
Surulere Local Government Area of Lagos State, Nigeria as the case
study.
1.8 Limitations of the study
This study has some limitations most especially in the area of
data collection. Financial constraints as well as time available for
the completion of the study are among other factors that would limit
the scope of the study.
1.9 Definition of terms
Health Care: The maintaining and restoration of
health by the treatment and prevention of disease especially by trained
and licensed professionals (as in medicine, dentistry, clinical
psychology, and public health).
Insurance:An arrangement by which a company or the
state undertakes to provide a guarantee of compensation for specified
loss, damage, illness, or death in return for payment of a specified
premium.
Group Health Insurance Plan:An
insurance plan that provides healthcare coverage to a select group of people.