Health Insurance – an Evaluation of the Effect of Health Maintenance Organisation in the Nigeria Economy

Health Insurance – an Evaluation of the Effect of Health Maintenance Organisation in the Nigeria Economy

Abstract of Health Insurance – an Evaluation of the Effect of Health Maintenance Organisation in the Nigeria Economy

This study focused on the operation and the evaluation of the effectiveness of the Health Maintenance organization. The aim of the study was to investigate if the Health Maintenance organizations who are the administrator of the scheme are running the scheme well in Nigeria. Further to investigate if access to medical care is cheaper with health insurance when compared to retainership. In order to achieve this, healthcare international as a health maintenance organization was studies. Literatures on health insurance were reviewed, questionnaires wee distributed to Healthcare international staff, hospital on the scheme, and enrolled population in the public and private organizations. The data collected were analyzed using percentage method The analysed data reveals that access to medical care is cheaper with health insurance but the health insurance scheme is yet to be properly operated in Nigeria as  there has not been enough awareness and understanding of how the scheme is operated. In conclusion it was recommended that Federal Government through the Nation Health  Insurance Commission and the health maintenance organization should create a mass awareness about health insurance and put in place measures on how is should be properly  operated in Nigeria.

Chapter One of Health Insurance – an Evaluation of the Effect of Health Maintenance Organisation in the Nigeria Economy

INTRODUCTION

Internal Auditing is an independent appraisal activity established within an organization as a service to it. It is a control which functions by examining and evaluating the adequacy and effectiveness of other controls.

It can also be defined as a control established within an organization, originally concerned with the financial records, investigative techniques developed by the control is now applied to the analysis of the effectiveness of all parts of an entity’s operation and management.

In any organization, the management usually sets out the plans including control procedures while the internal auditors supervise monitors and reviews as well as ensures compliance with such plans and control procedures.

However, large organizations are faced with various problems of co-ordination, control, public and employee relationship and general management. The development and maintenance of internal control system which is under the watchful eyes of internal audit staff is therefore of great important in this regard.

Internal control system can be defined as “a whole system of controls, financial and otherwise established by the management in order to carry on the business of the enterprise in an orderly and efficient manner, ensures adherence to management policies, safeguard completeness and accuracy of the record.

An internal Auditor must be free to review the whole internal control system of an organization. However, there is a sharp distinction between internal and external auditing.

The Auditing Practice Committee (APC) defined External Auditor’s duty as “Independent examination of and expression of opinion on the financial statement of an enterprise by an appointed auditor in the pursuance of that appointment and in compliance with any relevant statutory obligation. While an Internal Auditor’s duty is to prevent and detect errors and frauds by the management, the detection of frauds is only indicated in the case of external Auditors.

For an effective internal auditing program, the internal auditor must be independent; the independent of internal auditing department is to be responsible to an officer of sufficient rank in the organization to ensure a broad scope of activities and adequate consideration of an effective action on the findings and recommendations made by him. He should not develop and install procedures and prepare records which he would not be expected to review and appraise.

STATEMENT OF PROBLEMS / PROBLEM ANALYSIS

Over the years, doubts have been expressed over the effectiveness of internal audit, in the Armed Forces. Some of the factors responsible for internal audit ineffectiveness could be;

1.                 Does the ineffectiveness of internal audit result from shortage of professionally qualified personnel?

2.                 Is the head of internal audit department independent? Is he responsible to the assistant director or to the commander?

3.                 Does the account department prepare books on time so that the internal audit staff can carry out post-payment auditing?

4.                 Does the management give prompt attention to the audit queries issued by the internal audit department?

OBJECTIVE OF THE STUDY

In this research work, efforts are made to find the root causes of the multi-various problems being encountered by the internal audit department in the Armed Forces.

Intellectual universal remedy shall be offered to, as the ineffectiveness of internal audit in the Armed Forces.

The central purpose of this research work lies on the fact that an Internal Auditor is concerned with measuring and evaluating the continuous effectiveness of the internal control system. Therefore, if the internal audit department is reluctant, this may mean that;

a.                 The policies, plans and procedures set down by the management may not be complied with by the organization’s staff

b.                 The information required by the management to make decision may be incomplete and unreliable.

Recommendations shall be made as to the way by which internal auditing can be effective so that it can make a proper review of the operations, procedures and records of Nigeria Air Force’s Pay and Accounting Group.