1.1 Introduction
In the developed world, insurance in one form or the other is a veritable and sustainable tool for financing healthcare. 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. 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.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
Over the years, health insurance was first mooted in 1962 by Heuvi committee, which passed the proposal through the Lagos health bill. This study evaluates one of the cardinal objectives of good governance which is to have effective healthcare delivery system put in place for the entire citizens. A healthy nation is a wealthy nation because of the absence of debilitating diseases and epidemics in such a country, which, along with hunger and squalor, impoverishes the citizenry (Nwatu, 2000:12).
The United Nation and other groupings and organs 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”.
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Impact of Health Care Insurance Plans.
1.3 Statement of Problems
Investigation revealed that 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.
1.4 Aim and Objectives of Study
The aim of the study is to examine the Impact of Health Care Insurance Plans in Nigeria. In achieving this aim, the following specific objectives were laid out as follows:
- To identify the relationship between health care and insurance plan; and
- To determine the impact of health care insurance plan have on Nigerians.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Is there a relationship between health care and insurance plan?
- What impact does health care insurance plan have on Nigerians?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant impact of health care insurance plans in Nigeria.
- H1: There is significant impact of health care insurance plans in Nigeria.
Hypothesis Two
- H0: There is no relationship between health care and insurance plan.
- H1: There is a relationship between health care and insurance plan.
1.7 Significance of 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.
1.8 Scope of Study
The scope of the research is focused on the Impact of Health Care Insurance Plans in Nigeria using Enugu State University Teaching Hospital (ESUTH) in Agbani, Enugu State, Nigeria as the case study.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research Material: availability of research material is a major setback to the scope of the study.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.10 Definition of Terms
Health:
Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage.
Insurance:
Insurance is a means of protection from financial loss. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss.
Health Insurance:
Health insurance is a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses depending on the type of health.
Evaluation:
It is the making of a judgment about the amount, number, or value of something; assessment.
Health Service Providers:
This refers to any health institution (hospital, health centers clinics, etc) authorized to provide healthcare service under the NHIS (Ozuh, 2004:30).
