How to waste your health insurance, or not?

Dr. Animasaun was spending the night on call at the hospital. There were no patients to be seen but he was having a hard time sleeping. He decided to stroll to the lobby for some fresh air and passed behind the nurses’ station, only to overhear them talking about him.

“Many patients complain that Dr. Animasaun is very stingy. They even beg me not to take their folder to him…” one of the nurses said.

“Exactly. He doesn’t prescribe drugs as freely as the others. It’s almost as if you need to beg him,” the other said.

Dr. Animasaun’s heart sank. Despite all he did and how selflessly he worked, he couldn’t believe what they were saying. He turned around and went back to the call room. Why on earth would patients think he was stingy? After all, it was in their best interest. He had anything to gain if he didn’t prescribe unneeded medications. He shrugged his shoulders and slouched into the call room chair. Eventually, he dozed off.

——————————————————————————–

“Kukurookooooooooo,” the rooster crowed, at the crack of dawn.

Midun and her daughter, Deborah, hurried out of the prayer house where they had spent the night praying. The wooden doors squeaked open, and the fierce harmattan wind welcomed them to the outdoors. Midun was satisfied, hopeful that their prayers would be answered.

“Hurry up Deborah, ” she called to her daughter who was trailing behind. “We need to be home early enough to prepare for the day. By the way, the car keys are still with you right?”

“Yes, mummy,” Deborah replied, her voice barely audible.

“What’s the matter? You were shouting ‘Amen’ a minute ago and now you can’t talk?” Midun queried.

“I’ll be fine mummy. I just have a slight headache, my throat feels sore.”

“Sorry dear. Thank God. This is a good time to use our health insurance. Let’s go to the hospital!”

“But mummy, it would be too stressful to go to the hospital for this little thing,” Deborah said. “Let’s just buy paracetamol; I will use it and then sleep.”

“With which money?”

“Any money.”

“See your mouth like any money. You want the one I paid for health insurance to waste abi? Do you know how hard I work and you want me to still buy drugs that I’ve already paid for. My friend, give me the keys. You better enter the car and let us go, or else I’ll leave you behind,” Midun snapped as she opened the door to the car.

Deborah knew better than to argue with her mum, especially when she used that tone. She hopped into the car and remained silent all the way to the hospital.

——————————————————————————–

A knock on the door woke Dr. Animasaun up. It was 5:45 am. There was a patient to attend to.

He went quickly to the consulting room where Midun and Deborah were waiting for him.

“Good morning doctor. Sorry to bother you so early. We are just coming from a vigil and my daughter started complaining of a headache so I decided to bring her here.” Midun said.

“Is there fever or any other symptom?”

“No.”

“Well, what she probably needs is rest… to catch up on her sleep. Her voice may have been strained from shouting all night as well. I’ll prescribe paracetamol and lozenges though.”

Deborah who had been quiet the whole time had an ‘I-told-you-so smile’ plastered on her face.

“Okay. Vitamin C nko?”

“Nah. She doesn’t need it.”

“What of antibiotics?”

“She doesn’t need that either.”

“Ok. But please still write it for us. If she doesn’t use it then we’ll keep it in case someone else gets sick.”

“No. I won’t do that.”

“You doctors can be stingy sometimes. It won’t cost you anything to write it for us.”

Dr. Animasaun blinked twice. “You know that’s drug abuse right?”

“Well,… I just don’t want the money we paid for health insurance to waste.”

Dr. Animasaun sighed. Partial knowledge could indeed be catastrophic.

“Let’s get things straight. First of all, if I prescribe a drug you don’t need, it may cost me my career because I won’t be able to defend my prescription. Secondly, if I don’t give you what you don’t need, how does that make me stingy? If I do that I’m not helping you. In fact, that is what would waste your health insurance.”

“How do you mean?”

“Do you know how health insurance works?”

“Yes, doctor. One lady told us about the parable of the eggs. That’s how we even signed up for the health insurance program, to begin with.”

“Okay. If you remember, there was an estimation that two to three eggs could get spoilt but since they couldn’t tell which it was, they shared the risk by contributing equally.

Now imagine this. After three weeks, one egg says ‘Why am I paying this fifty kobo and nothing is happening? I need to use my fifty kobo so that it won’t waste. My shell needs a bit of polishing.’ So he takes ingredients of two naira each week to shine his shell. Then another one takes a hammer and smashes his shell so that his symptoms will look bigger. Then he demands more money from the contribution to treat his broken shell.

If this goes on, what do you think would happen to the target of having one hundred and fifty naira for the two or three eggs that may get spoilt?”

“Hmmmm. The target can’t be met.”

“And when some eggs actually get spoilt, will they be able to pay?”

“Not at all,” Midun said soberly.

“All efforts wasted! It’s like building something and then setting it on fire.

“Hmmmm. I get it now. Frivolous and unneeded expenses will ruin any health insurance program.”

“You’re brilliant!”

“Thank you doctor for being principled, and for taking the time to explain. And there I was thinking you were stingy. I’m sorry.”

“No big deal. You’re definitely welcome.” he said with a smile.

“Do have a nice day doctor.”

“And you too.”