Doctor’s Call To Ban HMOs Sparks Social Media Storm

By LOVETH-AZODO CHIJIOKE, Lagos.

A social media post by a Nigerian doctor calling on the Federal Government to ban Health Maintenance Organisations (HMOs) has ignited a heated debate over the effectiveness of Nigeria’s health insurance system, with healthcare professionals, insurance subscribers and industry observers offering sharply differing views.

The controversy began after the doctor criticised HMOs and urged the government to abolish the system, a position that quickly gained traction online and drew thousands of reactions from Nigerians sharing their experiences with health insurance.

Amid the growing debate, public health advocate and medical doctor, Aproko Doctor, sought to explain how HMOs work, using the traditional ajo savings model familiar to many Nigerians.

According to him, health insurance functions like a community savings pool where everyone contributes monthly, but only those who experience medical emergencies draw from the pool.

“In ajo, everybody eventually collects. In insurance, everybody contributes, but only the person with the emergency collects,” he explained, adding that health insurance is “like ajo where you pray you never have to collect.”

He argued that subscribers who remain healthy throughout the year should not regard their premiums as wasted, noting that they essentially purchased financial protection against unexpected illness.

Explaining the role of HMOs, he said they do not provide medical treatment directly but manage pooled funds and pay healthcare providers on behalf of enrollees.

He further noted that hospitals are reimbursed under different payment models, including fixed monthly payments regardless of patient visits and fee-for-service arrangements, adding that these structures often shape how hospitals perceive HMO patients.

The explanation generated mixed reactions.

Some Nigerians argued that expanding health insurance coverage remains the solution rather than dismantling the system.

One user, Nkemjika (@vangelickem), wrote: “All we can do is encourage Nigerians to get health insurance. With the large number of people in the scheme, most of these issues will be a thing of the past.”

Others maintained that the discussion failed to address broader structural problems experienced in countries with established health insurance systems.

Another user, Daoist ChEF (@daooffrancis), argued that while the explanation was informative, it did not sufficiently address the challenges facing mature health insurance markets, which Nigeria is attempting to emulate.

Some subscribers shared positive experiences with specific HMOs.

A user identified as Dazzling Gleam praised AXA Mansard’s digital platform, saying the company’s mobile application made it easy to understand health plans and locate accredited hospitals and pharmacies, while describing the response time as efficient in both public and private hospitals.

However, concerns over the treatment of HMO enrollees also featured prominently in the discussion.

Another contributor, Damie (@symplydamie), questioned why HMO patients often appear to receive different treatment from self-paying patients, asking why some hospitals maintain separate processes and whether HMO subscribers receive the same value for the premiums they pay.

The debate comes at a time when Nigeria is pushing to expand health insurance coverage under ongoing healthcare reforms, with industry stakeholders continuing efforts to improve access to affordable healthcare while addressing concerns over service quality, provider reimbursement and patient experience.

While opinions remain divided over whether the solution lies in reforming or replacing the current model, the online conversation has once again brought renewed attention to the role of HMOs in Nigeria’s healthcare system and the need for greater public understanding of how health insurance works.