It is quite appalling that Nigeria still ranks low among the World health organization member nations despite several interventions from international bodies and the establishment of the National Health Insurance Scheme (NHIS) tasked with enhancing access to quality and affordable health care and overseeing the activities of health insurance companies and health care providers.

The target of this scheme was to provide universal health care coverage to all Nigerians by 2015, but this has not been achieved as a lot of individuals are still faced with the burden of huge medical bills. The scheme has only been able to cater for a fraction of individuals in the organized public and private sector leaving out the unorganized population.

Several issues have been identified as reasons for this shortfall:

•A lot of individuals have no faith in the scheme
• Poor understanding of the scheme by clients and problems associated with overutilization
• Demands of robust benefit by the customer regardless of premium
• Healthcare providers accusing health insurance companies of non-payment
• Questionable treatment from accredited hospitals.

For the goal of universal health coverage to be actualized, every arm of the scheme (i.e clients, health care providers, health insurance companies) need to see itself as a key player and get involved. Clients need to have a good grasp of managed care so as not to act ignorant, ensure quality services are rendered to them when needed, and prevent unnecessary overutilization, knowing fully well that access to affordable and quality health care is a necessity and not a luxury.