President Donald Trump of U.S has floated the possibility of leadership change in Iran, hours after his team said replacing the Iranian government was not the aim of US attacks
However, Iran’s military vows a “decisive response” after Trump says US strikes caused “monumental damage” to Iranian nuclear sites – the UN’s nuclear watchdog calls for a ceasefire in order to inspect the damage
Iran’s foreign minister is in Moscow for talks with Putin about “common challenges and threats” – the UK’s foreign secretary is among those urging Iran not to escalate its response
Meanwhile attacks have continued. Israel carried out “one of the most intense attacks” on Iran’s military infrastructure overnight and a fresh “series of strikes” towards Tehran this morning, its military says
Both Israel and Iran seem to have ramped up their air strikes this morning.
In Israel: Iran has launched air strikes on Israel.
Around 8,000 people are without power in the south, with Israel’s main energy company reporting damage near one of its facilities.
No casualties have been reported by Israeli authorities
In Iran
Israel has also increased its attacks on Iran, which the defence minister Israel Katz says are being carried out with “unprecedented force”
Katz also says the targets in Tehran are the “symbols of the regime”.
Iranian military leaders have threatened a “decisive response” to the US, after America attacked Iran’s nuclear site over the weekend, and Donald Trump speculated about an Iranian “regime change”
There are also concerns Iran may close the Strait of Hormuz, a key shipping lane for global energy exports.
Elsewhere the US asks China to put pressure on Iran not to close the Strait of Hormuz, a critical shipping route
Ends
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Ends
Ends
We are most welcome to this 14th Annual General Meeting of Altimeters HMO. My name is Otumba Ali Koyewila, I’m the Managing Director and CEO of Altimeters. Sitting to my immediate left is the Chairman of the Board, Mrs Angela Jella.
And sitting next to Mrs Angela is our Company Secretary, Dr Tunji Adayemi. It’s our pleasure to welcome you to this main traditional HMO General Meeting. Basically what we are talking about is the fact that, as you all know, the federal government convinced the health insurance programme, it’s been 20 years this year, that was 2005.
And since then we all know that the growth has been somehow. But the fact remains that the economy of this country is a capitalist economy, whereby the private sector is driving the economy, while the government is regulating the economy. So as the health maintenance administration, we have been licensed to drive health insurance in this country.
And the share capital for the accredited health maintenance administration in this country, as we speak today, is 750 million for a national HMO. And as a very proactive organisation, we have decided to increase the share capital of this company to 1 billion. That’s the number one, 1 billion.
As we speak today too, our HMO is doing a lot of achievements. First of all, we have introduced health insurance to Nigerians that are living in the diaspora, to buy for their independence back home from us. And as we speak today, this health insurance programme is already being embraced in other parts of the world, starting from America to UK.
As a matter of fact, I want to share with you the fact that I just got back from Atlanta, Georgia, where we went to meet with the Consulate General of Atlanta, Georgia. And we were already interviewing with a lot of churches, mosques, and grocery stores that are being managed by Nigerians. Because the truth of the matter is, we currently have it on good authority, that quite a lot of funds are flowing into the country informally through Nigerians, sending money to their dependents back home, basically to assess health care.
And knowing fully well that health care is not a one-off service that you just go into the hospital and come out. It’s an ongoing process. So most of the time, people that have sent money just go into the hospital and pull out, and they eventually don’t go back because of lack of continuity of funds.
So we’ve seen that as a major challenge, and we have decided to address that challenge by interfacing strategically and vigorously with the Nigerians abroad, so that they can pay a token and erode their dependence on the health insurance programmes back home. In addition to that, we also want to share with you the fact that we are interfacing strongly with the regulatory agency to ensure that the agency, working with the federal government, come up with a regulatory framework to enforce compliance on the enrolment on the health insurance programme. The second thing I really want us to talk about, and because of sharing, highlighting the purpose of this meeting, is the fact that our team is working closely or will continue to work closely with the National Health Insurance Authority to implement the framework to enforce compliance on the enrolment of this programme.
And why we have to look at that direction vigorously is because Nigerians don’t have respect for others. We are all Nigerians, we see what we do on our roads when it comes to paying basic traffic lights. Everybody is a big man in this country.
So we know the challenges affecting the growth of health insurance in this country, and if there’s anything that Alternate Health is doing, it’s to work closely with the government at the regulatory agency level and even at the Ministry level, and also at any other level that we need to work with the government to ensure that we change the narration of our poor health indices in this country. You will agree with me that to grow this economy is our responsibility and not that of the Britons and Americans. So if we believe that the grass is green on the other side, the commitment of the management of Alternate and the board of this organisation is to ensure that we drive gradually towards making our own grass green in this country, because the truth of the matter is it’s our responsibility to develop this economy and this country.
So I want to yield to the chairman of the board to highlight some other aspects of this. Thank you. Thank you very much members of the press, thank you for being part of us this afternoon.
I just want to highlight the fact that we are very particular about the well being of our own needs, so that’s one of our priorities. And in fact I would claim that we are one of the best in terms of settlement of claims. And so that is our final bus stop, that is the purpose from which we settle, to make sure that everybody enrolled under Alternate and management organisation gets the required attention.
My MD just talked about those from the diaspora. We hear a lot of stories, we are the same money, nothing happens, nobody follows us and all that. And we are saying with Alternate that challenge will be mitigated.
We are very much aware of new customer expectations, we are aware of the rise for healthcare services. And one of the things, yesterday we had a retreat and one of the things we looked at was the fact that one of the things we looked at was the fact that we need to be more innovative, we need to see the common trends that are emerging, even in the health area, that we need to begin to tackle ahead of time, that people are not even looking at. So there is the issue of telemedicine, there is the issue of mental health, there is the issue of special needs of children that we need to begin to look at, and look at the entire body of the health insurance.
And so as Alternate we are leading the pack, we are making sure that we are blazing the trail, in thinking ahead, in being agile in our movements, and also in making a modest profit, so that shareholders can have something to take home and be proud of the organisation where they are investing. So those are some of the things that we are doing. Thank you.
In contrast to what has just been said by the Chairman of the Board, I think it’s important for me to add the fact that focussing more on the innovative aspect of her presentation, or what she has just said, we have decided as an Administration to expand the package that the federal government is providing for the federal civil servants in this country.
And the expansion is basically, what we are adding to it is what we call pre-booking system. Pre-booking system is a system whereby, because we have understood the programme, you see that most of the time when people go to their chosen hospital, they practically spend the whole day before being attended to.
Recently the regulator came up with a mandate, with a directive, that the minimum waiting time for aerobics on this programme should be a maximum of one hour. And when we got that message, we put on our thinking cap in all teams and it’s like, if before now, what else have we been doing? We’ve been, like the Chairman said, standing out in the area of provision of quality or qualitative healthcare services to our employees. The maximum waiting time for a team leader, I tell you today, is ten minutes.
And we want to reduce that to a minimum of five minutes. Because we have already deployed a very robust software to deal with that. In addition to the software now, we now say, okay, why can’t we come up with a concept of inclusion of pre-booking system, whereby if you want to go to your hospital as an enrollee of all ultimates, you call us and tell us, you are going to see your doctor or to your hospital, yesterday or Monday, we will call them in your hospital and say, you are coming on Monday at 12 o’clock.
As a matter of fact, that Monday morning, we will give them another call, reminding them you are coming. Because we’ve seen what is being done abroad. I want to share with us this afternoon.
Pre-booking is part of the booking. You can’t just wake up and go to your hospital without being expected. And the fact is that this country is a member of the global community.
So if we are a member of the global community, we must be safe driving. If we are a member of the global community, the pace at which we move certainly may be different, but the fact is that we can’t afford to be stagnant. So we have introduced that already.
In addition to that, we have also implemented a process to enhance vigorously and strategically the implementation of preventive healthcare. Preventive healthcare is going to be very paramount in terms of the services being provided by our teammates as we speak. The internal operational process and procedures is being completely overhauled to ensure the seamless implementation of this, because we are facing a challenge whereby everyone that’s enrolled on the health insurance programme is just the issue at hand and everything the people do is just walking to their hospital, basically focussing on curative.
And we all know that prevention is better than cure. So we take about 70 to 75% of prevention to really ensure that the populace are well and because people can use the preventive programme to enhance their lifetime and also enhance how best to live right. So we have deployed all of this and all of this have been vigorously reviewed by the board and it has also been approved for direct implementation by the board.
So if there’s anything that we also want to say in conclusion is to continuously seek for your support and collaboration, such that whatever is positive about the sector is what we focus more on. Because some of us are quite exposed to what goes on across the globe and you’ll be so shocked and amazed that over there whatever is negative is downplayed. So it’s like in the whole front your parents are fighting, you don’t go out on the field or on channels to announce that.
So we’ll continue to support, seek for your support and collaboration in this regard and in other regards that will be required. So it’s a pleasure having you around. We want to thank you so much.
Thank you. The difference between our team and others is the fact that this business is driven with a lot of integrity, a lot of truthfulness, a lot of corporate governance, a lot of best practise. So whatever we say is what we do.
And you can find out more about how many of the health and maintenance organisations are actually doing what we’re doing. And that goes to tell you what I have to say. I want to thank you so much for that question.
First of all, health care is a right of everyone. It’s a right to everyone. Are you getting me? So the introduction of health insurance in this country is just to strengthen the access to enjoy that right.
Now if you look at the structure of the organisation, I guess we do have 10% of Nigerians that are at the high level. Why should a health and maintenance organisation should be focussing more on those with deep pockets that can afford to pay out of pocket? This health insurance programme I want to reiterate at this point was designed for the population, for the people at the low level that don’t have that access, don’t have that financial capability to access care as a community. So the focus is more on the masses and not the top echelons of society.
Because if you can enjoy that effortlessly, so we are targeting the masses and we have the masses in mind. My reality is so straightforward and very simple one. I have been opportune to sit on the governing council of NHI before.
I have also been the spokesman for the association of HMOs in this country between 2016 and 2020. And part of the issues that I have addressed and still insist that should be addressed is the fact that the health and maintenance organisations structurally are expected to settle bills properly and regularly. And we’ve implemented the introduction of sanctions for non-compliance with that.
So as far as I’m concerned, and as far as all Tibetans are concerned, based on what the chairman said, a major part of our unique selling proposition is prompt settlement of bills. It’s not discussable as far as we are concerned. It shouldn’t be discussed.
If service is provided, we are expected to settle bills. And that’s why globally business business is no longer postpaid. It’s now prepaid.
Or should we continue to drive this business on the concepts of postpaid, provide the service and send the bills? The issue is there’s a timeline already that has been set by the regulatory agency for that. So non-compliance is on the verge. And sanctions should be applied.
So part of my position, which can be confirmed from the regulatory agency, is that I have always been a party to the fact that things must be done right. Because part of the challenges that we’re facing in this country that is affecting our growth is lack of respect for our rules and regulations. It’s lack of respect for our laws.
We have little or no respect for all of those things. And of course, when somebody begins to take the bull by the horns and insists on the right things to be done, we probably will not go too far. The second one is on, you mentioned earlier that the regulatory agency directed that patients should be of associations led by women or female members.
There are about 80 professional associations under the coalition called the Association of Nigerian Women Business Network. And so we had an interface with them to get all their women registered under the NHIS programme. So that the women, especially those that were female farmers in the rural areas, to get them registered under the Act.
You don’t have a programme for them to pay you monthly or something. Some have, some haven’t. So it’s an ongoing thing.
Because you still need a lot of advocacy. Because it’s not free from the side. They have to pay for the service.
And so it’s something that is still ongoing. But I assume that’s what you… Yeah. You see, the best approach to bring the volume of enrolment in this sector is when you come up with clusters and provide them not necessarily something that is quite peculiar, or something that also could serve their purpose, okay? So when we look at that particular group of women, they are spread across the country, we saw the need for us to reach out to them and see what we can do for them.
Also that they are into subsistence businesses, as if it was doing their business. For example, because of putting them together, we discovered a lot of challenges, operational challenges. First of all, they have no banking process.
So they have no relationship with any of those banks. So the first leg of our relationship with them was to have now partnered with a bank, or two banks. Because I want to share with you that we went as far as partnering with Unity Bank, also went as far as partnering with Fidelity Machinery Bank, so that they can now open an account with those banks.
First of all, use the accounts to begin to pay their premium on a solvent basis. And as soon as they achieve certain percentage, about 50% of the premium, they can be activated on the programme where we will give them additional 90 days for them to fully pay their premium. Along the line, we discovered that it was also a major challenge for even the bank to interface with them strongly.
There are a few of them that showed interest, but eventually we also discovered that for them to even pull their members together, it was a headway and task. So eventually by the time we received the association membership, what was said to be strong in terms of membership that are committed was nothing to write about. So that really took us back.
Maybe what we are going to do is to now go back to the political pooling of the government and see how we can drive this through the government. If the government now drives enforcement of compliance, it becomes mandatory for everyone. Because the way the government is thinking now, which is what we are looking at from the perspective of the SGM, is a concept whereby if you have a store or you have your child in a particular school, part of the process of enroling that child in that school, what you are paying the school is evidence of health insurance.
The same thing, renewal of your driver’s licence, renewal of your vehicle licence, all of those concepts are being put together now. So that was why we systematically shrunk that down for now. I want to review that.
I would like to be very objective about this. If you look at the volume of enrolment on this programme now, as we speak today, I would say that it is not quite encouraging. But I also would like to quickly add to that.
The fact that at the moment what we are looking at is a process of recalibrating the programme and to drive enrolment.
For instance now, before we embark on this interaction, I have mentioned to the board that I was going to meet with, we were going to make a submission promoting it to the management of NHIA, looking at the tertiary institutions across the country. In that sector alone, there are over 20 million natural youths between the age of 18 and 25.
They have seen the need for that to be done as well as tertiary 6. And that was why they introduced tertiary. But it hasn’t really been grown. There was nothing to, it hasn’t really been put together for enhancement of enrolment.
The majority of tertiary institutions seem not to see it as a way to go. And it’s because of the challenges that we know and we have evidence. So what we are looking at after this outing is to see how we can completely recalibrate the, yes, is to completely recalibrate, put some paper to the NHIA for the review of the tertiary institutional health insurance programme.
And what I said there is so simple and straightforward. It’s just for them to put together a criteria to look at what is the appropriate premium that should be paid by the tertiary institutions, by students in one session. As we speak today, it’s just about 2,000.
If you multiply that 2,000 by 12 months, it’s just 166.66. So what does this cover? What quality of care can that provide? We have discussed this. We have undertaken this. So we propose that to NHIA.
Knowing fully well that the law has been passed as of 19th of May, 2022, to make health insurance mandatory. So we need to hit the ground running. We need to take the bull by the horn and begin to implement some things strategically.
And what we are going to propose, let me run it by you quickly so that you can begin to highlight this while we are doing the consultation paper. We will encourage the regulatory agency to work directly with the Federal Ministry of Education. And the Federal Ministry of Education now working directly with the NCURUC for the universities, NPTA for the technical colleges, and SCC for the polytechnics also.
I say SN, okay, whichever way it is. And what they are going to do is just call these three regulatory agencies together and give them a matching order based on where the university is. All tertiary institutions must be enroled, must enforce enrolment.
And I want to share with you quickly, it’s not a new thing to the tertiary institutions across the country because they’ve been collecting medical allowance since God knows when for most students. Are you understanding me? So what they just need to do is enforce compliance. Thereafter, divide, you know, look at the geographical zones and allocate six HMOs to one HMO each based on the geographical zone.
That will drive volume. And whatever we are looking at, that volume can mitigate the risk exposure. So we are looking at that for now.
What I’m sharing with you today, already we’re discussing with the leadership of the National Association of Nigerian Students. They were in our office when we discussed this. So we’ll be writing, we’ll be dealing with this among other programmes that we’re pushing forward to implement through the ages.
So what… We understand quite a lot of things, or a lot of requirements, especially a lot of the operational process of this health insurance programme.
And the same thing for the health maintenance organisations that are managing the HMOs are now managing the risk at the secondary and tertiary levels. Before now what was being paid to the HMO was low. As we speak today, what HMOs are meant to do is to warehouse 700 across the number of lines they manage and any approval that is given from the contact centre of the HMO is meant to be honoured by the time the bills are sent to them, the ventilators and picking facilities within two weeks.
There are two laws in the health insurance industry, the first law and the second law is our operational guidelines. That is the bible of the business. That is the front of the business.
So whoever does not comply with that. I want us to highlight this because so many of the HMOs seem not to understand who bears the risk. So many of the HMO providers have been fearless and seem not to have that understanding so let us clarify that.
