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SGF, Yayale in N50 Billion Health Insurance Scandal

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Dr. MBW Dogo Mohammad, NHIS Boss
The Secretary to the Government of the Federation, Yayale Ahmed, is currently enmeshed in a multi-Billion naira scandal. The scam involves the Federal Government N50 Billion contribution into the National Health Insurance Scheme (NHIS), led by Waziri Dogo-Muhammad, his kinsman from Bauchi.

Yayale and Dogo's action have led to the death of Millions of Nigerians who do not have Health Insurance and cannot afford hospital bills.

This is coming on the heels of the imminent sack of Ahmed by President Goodluck Jonathan, sequel to revelations that he pretends to be a member of the People's Democratic Party (PDP), in Abuja, while back in Bauchi he is a top ranking backer of the Action Congress of Nigeria. Said our source “His brother who worked for NIMASA , ran for Governor under the Action congress in Bauchi, financed by him. Even though he would have been considered for another position if another zone gets the SGF, he may go the way of Capt Ihenacho, the suspended Interior Minister from Imo state” learnt that in June 2005, the President Olusegun Obasanjo formally flagged off the NHIS with a takeoff grant of N26 Billion, and in 2006 another N24 Billion was approved for the NHIS all in a bid to make the scheme a reality.

But instead of ensuring that all of the funds get to the Health Care Providers Association (HCPA), through the Health Maintenance Organizations (HMO's), Dogo-Muhammad with technical advice from the SGF, decided to put the cash in fixed deposit accounts. The first lodgments were made in 2006. gathered that some of the banks are Zenith Bank, GTBank, and Unity Bank, formerly known as Universal Bank.

The NHIS was set up under Act 35 of 1999, with the aim of providing easy access to health care for all Nigerians at very affordable rates through various pre-payment systems . It was officially launched in 2005, while commencement of services to enrollees commenced in September 2006.

Despite the huge funds available to the NHIS, it covers no more than 3 per cent of those eligible.

Our source said, in 2006 Dodo-Muhammad was made national coordinator of the scheme. He was seconded from Federal Ministry of Health. This move was masterminded by Yayale Ahmed , who was Head of Civil Service under Obasanjo.

According to a top NHIS source who did not want to be named because of the sensitive nature of the issue, Ahmed and Dogo-Muhammed have made over N5 Trillion, as interest from this fixed lodgments.

Dogo-Muhammad's tenure had been dogged with controversy but, Ahmed has done everything in and outside the books to ensure the NHIS boss keeps his job. Shortly after he was brought from Bauchi, the NHIS boss applied for leave of absence but was advised by Ahmed to apply for transfer of service instead. In 2009, he applied for retirement from the Health Ministry so he could continue at the NHIS, but this move was blocked by then Head of Service, Steve Oransaye. He wanted him to retire and leave the NHIS. He went to court to get an injunction restraining the Attorney General and Health Minister from forcing him out. Ahmed later arm twisted then Acting President Jonathan to allow his kinsman run the NHIS till 2012.

Said the source” they have been moving a large chunk of this money since 2006. They put it in fixed accounts, and live on the interest which has run into over N5 Trillion…The banks include Unity, Zenith, and GTBank. The two of them are doing all they could to ensure Dogo-Muhammed stays on. That's why they fought (steve) Oransaye. “

Our source continued “when the scheme took off the Federal Government made available some funds as take off, since the scheme is contributory. First was N26 Billion then it went up to about N50 billion. “

Although, Dogo-Muhammad or his spokesperson could not be reached, a top officer who wanted to remain anonymous because he was not authorized to speak for NHIS said “ some of the problems are caused by the Health Maintenance Organizations (HMO), who failed to pay the health care providers despite available funds. I am not aware any cash was fixed anywhere. We spend no less than N889 Million every month on coverage for families, children, maternal, pregnant women etc”

Contributions are earnings-related. The employer pays 10% while the employee pays 5%, representing 15% of the employee's basic salary. However, the employer may decide to pay the entire contribution. In accordance with the existing contractual agreement between employers and employees, especially in the organized private sector, an employer may undertake extra contributions for additional cover to the benefit package.

The contributions paid cover healthcare benefits for the employee, a spouse and four (4) biological children below the age of 18 years. More dependants or a child above the age of 18 would be covered on the payment of additional contributions from the principal beneficiary. 

However children above 18 years who are in tertiary institution will be covered under Tertiary Insurance Scheme.

Healthcare providers under the Scheme shall provide, among others, the following benefit package: Out-patient care, including necessary consumables Prescribed drugs, pharmaceuticacare and diagnostic tests as contained in the National Essential Drugs List and Diagnostic Test Lists;

Maternity care for up to four (4) live births for every insured contributor/couple in the Formal Sector Programme; Preventive care, including immunization, as it applies in the National Programme on Immunization, health education, family planning, antenatal and post-natal care;

Those eligible are reuired to obtain an NHIS card, which they would present at approved health care centers(public or private) listed by NHIS.