Moral hazards and service delivery: Evidence from National Health Insurance Scheme in Jos Metropolis

Abstract

Operational efficiency of health sector in term of medical facilities and availability of vaccines is crucial to the performance of National Health Insurance Scheme (NHIS) accredited hospitals. At the same time, availability of qualified medical doctors and effective management of queue are also important to enrollees’ satisfaction. In order to determine whether the NHIS hospitals are efficient in service delivery, the impact of three key variables including operational efficiency, information asymmetry and moral hazard were tested on service delivery in health sector. The study revealed that th e selected hospitals are efficient in service delivery by 26.4%. However, the health care providers are found to exhibit a kind of moral hazards and nondisclosure of information about NHIS services which lead to reduction in service delivery by 5.2%. Similarly, information asymmetry and moral hazard were found to be responsible for 31.9% of health risk behaviour observed among the NHIS enrollees. Meanwhile, it was found that a small magnitude of efficient service delivery leads to reduction in health risk behaviour by 5.4%. Hence, the study concluded that the 32% of efficient service delivery is due to operational efficiency, information asymmetry and moral hazard while about 31.9% of health risk behaviour among NHIS enrollees is due to information asymmetry and moral hazard exhibited NHIS primary healthcare providers. We recommend that NHIS primary health care providers should try as much as possible to reduce their involvement in moral hazard that distorts the achievement of NHIS primary objective of making healthcare accessible to all enrollees.

Keywords: moral hazard, health risk behaviour, health insurance, public hospitals