Nigeria and the United States Share a few things in common. The main feature is the cultural diversity. Nigeria has 36 states and within those states are different groups that multiply into over 100 cultures. In America, there is a similar interaction within its 50 states.
There are many people and tribes, though, with America, it's more so among immigrant continental lines in Nigeria. These cultural differences are based on the origin of the tribes in question but one could still argue that it's all still based on immigration because no one tribe in Nigeria arrived at its current settlement from nowhere.
Many people would hate to think that the founding fathers of this once great country had anything in mind when it was being created but it does appear that our healthcare system was built around the US's framework.
I had this discussion with my elder brother @belemo when I was under the impression that the US had the best healthcare system when in reality, the healthcare for patients is one of the worst in the Western world. This doesn't kill my love for America's Economy I just don't think it takes care of the health of its people.
The solution may not be as obvious as many would like it to be and that's for the US to grapple with. Similarly, the Nigerian health care payment is deeply flawed and I have proposed universal basic health care like in the UK.
In this post, I will be considering the UK and the US payment systems and the problems with full adoption.
Universal Healthcare in the UK
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I've heard mostly good things about UK healthcare the coverage seems all-encompassing and includes almost every condition chronic and acute. This is especially true for medical conditions. Dental problems are hardly touched.
The healthcare provided is divided into primary and secondary then Emergency care altogether.
The coverage usually stops when cosmetic surgeries, adult care (long-term care homes), and alternative care are being considered.
The problem people have with UK healthcare is the long waiting time. More than half of the patients in the NHS say that waiting time leaves a bad taste in their mouths.
Because of the nature of the dependency of the NHS on government resources directly. Pay for healthcare staff is directly affected by changes in government policies.
I had a conversation with an informant about 6 months ago who expressed displeasure saying "Why can't they just increase the pay of these doctors".
The government of every country fights tooth and nail against these sorts of changes because as much as everyone wants an unlimited amount of resources there is no such thing.
Eventually, all that happens is that resources are moved around. One aspect of daily living eventually suffers.
As of September this year, the government responded to the plea of doctors around the country for pay raises to meet the demands of the UK economy.
Hopefully, as countries continue to recover from the great blow that was COVID there might be light at the end of the tunnel.
Nigeria has been described as a middle-income African Nation which is a more palatable way of saying that we are a poor nation. Poor nations can't afford universal healthcare. Nigeria is uniquely poor in this regard as we are mostly poor because of the allocation of resources.
It is no secret that the cost of government personnel is one of the biggest expenses in the great green white green.
The US payment system
The US health payment system does not share the same problems as its counterpart in the UK. The main feature in the US that makes them distinct is the private insurance companies that cover some medical conditions.
While the vast majority of insurance companies cover normal hospital visits (annual checks, routine checks, specialist visits) and some surgeries, there are many grievances about the system's claim denials. Some of the richest insurance companies in the US have the highest turnover rates every year.
The best part about the US system is that getting insurance is not hard because most employers are required to give their employees some form of coverage even though most have been described as trashy.
The one advantage of the medical system in the US is the fact that it is not over saturated and at least you might meet a doctor early but many have argued that the system doesn't care that you are sick with some schools of thought arguing that the doctors are not thought to keep you healthy as opposed to managing illnesses.
As a medical graduate in Africa's most populated nation, I have to confront the origin of my knowledge topics of weight loss and healthy diets most of which were gathered in Biochemistry and not exactly re-enforced in clinical medicine.
The US healthcare has been a topic of debate for the past couple of years and several presidents have been perplexed by how deep the problem is with recent Presidential nominee Donald Trump assessing that his cabinet has "concepts of a plan".
Some attempts have been made to fix the system with social medical care like what goes on in the UK but all that has been achieved was to make private insurance more expensive. This was the main sentiment against Obama Care (Affordable Care Act). With this Care Act here to stay many Trump and Joe Biden have done what they can to salvage the plan but with little success.
With Nigeria forging towards this direction of the US, there is not enough data on insurance denial claims. So far the opposite has been the case in terms of the effect of social medical care. The closest to this we have is the NHIS which stands for National Health Insurance Scheme and to say that its coverage is bad is to give it props.
Out-of-Pocket Payment
In Nigeria, over 50% of our healthcare payments are with debit cards and hard cash. This is because health care is still relatively affordable. Take routine doctor visits for example cost N5,000 (about $6.66) which is about $300 to $600 in the US and about 50 to 100 Euros in Australia.
However, because of Venezuela's currency's value, the cost of seeing a doctor is half that of Nigeria.
The problem with OOP payment is the lack of insurance, who would have guessed it? The insurance this time not being available for the health care.
Imagine providing first aid for a patient, and the patient feels better and leaves with the services and products used in the procedure. Most times, when people in healthcare try to complain about it, some members of the public say we should derive fulfilment from our jobs and not seek financial incentives.
While Out of out-of-pocket payment does not seem like a decent plan when emergencies arise, there are solutions that could help the healthcare team and the patients.
A modified savings plan that is accessible to the healthcare team would not only solve the problems faced by most Nigerians who are not insured, but it would also save the hospital management from losses.
Savings like this have already been instituted in the US. Why do I have to take money from a gathered pool (as you would do regular insurance) for your health care when I can check your health savings and work with you to devise a plan for your health care?
There are foreseeable problems with this form of OPP payment but it works well for young people who are not in industries that put them at risk of physical harm.
As you get older you might want to consider getting some form of insurance especially if you are dealing with any chronic disease.
References
- Healthcare in the UK: understand how the NHS works
- Is cosmetic surgery available on the NHS?
- End of life care in a care home
- UK Government Offers Junior Doctors Pay Rise of 22.3%: Everything You Need to Know About the New NHS Pay Deal 2024
- 2024 Budget Revenue Breakdown
- Health insurance in the United States
- Which Health Insurance Company Denies the Most Claims?
- https://www.americanprogress.org/article/health-insurance-costs-are-squeezing-workers-and-employers/
- Health Insurance Costs Are Squeezing Workers and Employers
- Obamacare Has Doubled the Cost of Individual Health Insurance
