Am I my brother’s keeper? Why Universal Health Coverage begins with You

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What can you do today to make a difference and be your brother’s keeper? Photo credit: Nigeria Health Watch

Editor’s Note: This week’s Thought Leadership piece comes from Obinnia Abajue, CEO Hygeia HMO Limited, a Health Maintenance Organisation (HMO) based in Lagos. The article is a synopsis of Abajue’s riveting talk at the 2017 Future of Health Conference themed “The Business of Health,” where he argued the case for Health Insurance Coverage. He noted that one important way to ensure that your health is protected is to make sure that those around you have the health care and coverage they need. Watch his full talk in the embedded video. The article is edited and published with permission.

By Obinnia Abajue

Let me begin with a quick reminder of a Bible Story some of us were taught as children; the story of Cain and Abel, found in Genesis 4. The important part is v9:

Then the Lord said to Cain, “Where is Abel your brother?” He said, “I do not know. Am I my brother’s keeper?” Thereafter God cursed Cain for how he had treated Abel.

We are tempted to dismiss this as just another story, with no connection to real life but any keen observer of the Nigerian healthcare system may see a reflection of Cain’s question — “Am I my brother’s keeper? — in the management of healthcare in the country. My goal today is to challenge us to take a bit more responsibility by changing our approach to the subject of healthcare coverage.

I will like to highlight three important facts about healthcare, which I believe will help us understand, from a general society viewpoint, why we need to change our approach to the subject of health coverage:

  • Healthcare is an interconnected system — No man is an island. If your neighbor is sick, it is only a matter of time before you become sick. If your community is sick, productivity becomes irrelevant. Then, imagine if a whole nation is sick… This is why there are communicable diseases and epidemics such as Ebola, Cholera, Meningitis and Hepatitis B. Healthcare is not only about curing diseases, it is a very large and complex value chain that begins from prevention or avoidance of disease.
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There is no rich-poor divide with healthcare

In August 2014, at the heart of West African Ebola crisis, Dr Stella Ameyo Adadevoh, was her brother’s keeper and helped prevent the spread of the virus in Lagos, at the expense of her own life. When Ebola hit the shores of Lagos, it came via the rich — the passenger was able to afford a flight to Lagos to escape his own Ebola-ravaged country, Liberia. In Lagos, he went to a private hospital, where the rich go. There, Dr. Adadevoh gave her life to see that the disease was contained even before the government stepped in.

You see, even though it is a social good, (defined as something that is of necessity to all in the society), the difference between healthcare and, power, roads and other utilities is: you can’t do a workaround with your health. You cannot get an alternative to blood or to oxygen for someone in need of it. You cannot delay or extend the four minutes that the human brain survives without oxygen; there are no fake spare parts, or repeatable contracts for the repair of the human body in need. A stroke does not discriminate by bank balances.

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So, we must get the basics of healthcare right, with or without government support. We must do right to ensure that we survive as a community and a country. To do so, requires us to set up risk pooling systems that help to protect us by creating the capacity to pay for healthcare once you belong to the pool. That pool is our Health Insurance System.

This is a national crisis that can only be resolved by the people.

Many families have been impoverished by the cost of a major illness in the home — immediate or extended because there was no plan to manage the risk.

I know you have questions and concerns:

How do I know the Health Maintenance Organization (HMO) will pay when I need to use the plan?

  • The same way you know that when you buy something from anyone, it is what it says it is and it does what it says it will do.

What can I do today?

  • Get involved. Buy a plan. Ask questions and improve your understanding of how it works.

I honestly don’t think I can afford to pay for health insurance

  • There is a plan for every price point. You don’t have to buy an expensive cover. But buy something.

What can you do TODAY to make a difference and be your brother’s keeper?

Be your brother’s keeper, get a health insurance cover today for you and your family; and help someone else; your worker, dependent, relative… to pay for a plan.

Originally published at

We use informed advocacy and communication to influence health policy and seek better health and access to healthcare in Nigeria.

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