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EXPERTS at the 40th-anniversary reunion lecture of the Ibadan College of Medicine Association (ICOMAA) 82 class say that medicine is a business, and ensuring that universal health is attained by all will require the enforcement of mandatory health insurance coverage in Nigeria.
At the occasion, the ICOMAA 82 class represented by Professor Folasade Akinsola, the class coordinator, presented an N40 million cheque to support the construction of new hostel accommodation for the college.
Chief Operating Officer of Afya Care-Cornell University, Mr Kola Oni, in a keynote lecture on ‘Medicine as a Business: Investor’s Perspective’ said the case for tertiary and advanced secondary care is clear, as the disease burden patterns in the country have shifted in 10 years to urban/lifestyle diseases while primary care level malaria and infections have declined.
Mr Oni declared that challenges in healthcare that had held the sector back for decades included the scalability of many hospitals, poor capital management and synergy, corporate governance and quality of investors in the health sector and poor workforce incentives.
“Most hospitals run as one-man or family businesses and usually fail once the founding physician dies or retires. Outside the physicians, most other skills like accounting, administration and even nursing are rarely optimised or developed.
“Efficiency of hospital operations revolves around the design. Converted residential and commercial properties have difficulties achieving optimal efficiency levels; many facilities are small and so lack scale economies and there is always poor long-term and working capital management.”
Mr Oni said that Nigeria’s population is a key driver of healthcare demand; that all men and all hospitals are not created equal and therefore public sanitation, universal health insurance, health security/infrastructure, human capital management and a regulatory framework for standardisation need to be addressed to best position the healthcare space.
Dr Leke Oshuniyi, who spoke on ‘Medicine as a Business: the Health Management Organisation’s Perspective’, stated that the future of health is managed care and that health insurance cover 95 percent of all prevalent diseases in Nigeria.
According to him, individuals need to have health insurance coverage because medical inflation is higher than economic inflation and so care must be taken that healthcare does not impoverish a nation.
Chief Medical Director, University College Hospital (UCH), Ibadan, Professor Jesse Otegbayo, speaking through Dr Abiodun Adeoye, puts UCH’s overhead at N12 million per month, and that the facility spends on electricity N62 million aside from waivers on treatment for indigent patients and cost of diesel, among others.
“We are losing a lot of money and, yet the hospital must not be shut and we have to keep it running. So, really, we must have the business acumen to keep the hospital standing,” he noted.
Chairman at the occasion, Professor Oladapo Ladipo, who applauded the achievements of the college despite considerable challenges, in particular financial constraints, urged the college and its alumni to invest more in research to remain relevant and competitive.
He stated that endowment plays a crucial role in tertiary institutions and the college should not be discouraged by any challenges it faces while trying to raise funds to complement funding from the federal government.
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