Healthcare cost bites as bills cage patients in hospitals after discharge
Nigerians who are already hit by economic recession and soaring food prices are contending with rising cost of healthcare services – a condition that has plunged patients into debt and caged them in hospitals even after discharge.
The cost of service delivery in
deadliest diseases in Nigeria has moved up by a minimum of 10 percent, compared with rates charged during precoronavirus days, sources in government-run hospitals in Lagos inform Businessday.
A combination of this increase with the cost of medical investigations such as the mandatory Covid-19 test and medical consumables implies that the out-of-pocket burden is heavier and worsened especially for people in the informal economy who are less likely to be protected by a health insurance scheme.
The 14.23 percent headline inflation in October partly led by increases in the cost of food and transportation initially seemed like the last straw for many Nigerians, particularly 87.9 million people estimated by the World Poverty Clock as extremely poor.
But out-of-pocket expenditure already contributing $12.3 billion, about 80 percent of the total healthcare spending, is now on the bucket list of people’s woes.
Regrettably, 2020 has seen household finances overstretched under an economy experiencing its second recession in five years. The purchasing power is lower, to the extent that it leaves people with barely anything after spending on feeding, clothing and shelter.
Consequently, surviving medical emergencies has become increasingly difficult. Some of those who fortunately survive and are eligible for discharge cannot go home because they have been unable to raise the fat medical bill accumulated.
By the time Patience Uwem is free of debt to leave the Lagos State University Teaching Hospital (LASUTH), where she has been hospitalised over the last three months, there won’t be a home to return to, Godwin Uwem, her 21-year-old son, told Businessday during a visit to the hospital. He sold shawarma at a local club before his mother’s sickness forced him to quit.
Exhausted, Godwin has been forced to write the chief medical director, seeking the slash of the rising debt of close to N500,000.
After being diagnosed of Tropical Diabetic Hand Syndrome (TDHS), Uwem Patience was admitted on August 17. She has undergone surgery that left her aboveelbow right arm amputated.
“I have spent all I have and sold everything I could and right now I’m in debt. My mother became a widow last year after my dad died from a sickness that drained our family financially,” said Godwin Uwem. “We were barely recovering when this illness struck my mum. Our extended families are exhausted also. We are probably going to start living in a church if we are lucky to pay this hospital.
My landlord has evicted me already.”
In Uwem’s ward alone, there are three other patients stuck because they can’t raise their medical bills.
Some families like the Uwems have increasingly turned to social media to plead for public help, uploading images of sick relatives and their medical bills.
In October, popular Twitter doctor, Chinonso Egemba, aka Aproko Doctor, launched a funding platform to support people stranded in hospitals in response to the stream of daily requests for help trailing his inbox.
The goal is to raise N5 million, out of which N838,420 has been raised by 150 donors.
“My heart is broken by the amount of messages I get on a daily basis seeking help to offset medical bills. Some of them don’t have the luxury of time. Some are close to death. I want you to join hands with me to help as many as we can,” Egemba tweeted in October. Admission cost rises
For all emergencies, Businessday found that while admission might be free for the first 24 hours only, subsequent daily stay in an emergency ward now ranges between N3,571 and N 7,142, feeding included. Previously, the rates ranged between N3,285 and N4,285.
According to a Global Burden of Diseases (GBD) study by the Lancet Publication, neonatal disorders, malaria, diarrheal, lower respiratory infection, HIV/AIDS, ischemic heart disease, stroke, congenital defects, tuberculosis, and meningitis were the 10 leading causes of death in Nigeria as of 2019.
Management of these diseases often requires laboratory investigations - and the cost has also inched up.
For lower respiratory tract infection, for instance, a breakdown of medical investigations required, depending on severity include: nebulisation, now N1,300 as against N1,180; oxygenation, N13,000 per cylinder as against N11,820; full blood count, N2,200 as against N2,000; a test of electrolytes, N3,900 as against N3,550, and creatinine, N1,300 as against N1,180.
Overall, the disease could gulp at least N103,050 outside surgery, a cost that could take a minimum wage earner three months to raise even if exempted from personal income tax as being proposed by President Muhammadu Buhari.
For some analysts, achieving an inclusive economic growth will go a long way in bolstering the disposable income available to households, which will in turn affect health.
Also, the World Health Organisation (WHO), in a health systems governance and financing policy note, established that continued low level funding for health services goes hand-in-hand with high out-of-pocket expenditure.