Why Most Health Resolutions Fail (2)

• Planning for Health Is Planning for Life

For many Nigerians, illness is not merely a health crisis; it is a financial earthquake. The diagnosis comes first, panic follows, and then begins a desperate scramble for survival. Patients and families turn to media houses to broadcast their plight and solicit funds. There are frantic calls to relatives, messages in WhatsApp groups, appeals to religious communities, and, too often, the painful sale of assets built over a lifetime. Some resign themselves to fate, watching loved ones writhe in pain until death intervenes. The true tragedy is not that sickness occurs, but that most people are financially unprepared when it does.

As conversations around New Year health resolutions fill the air, one critical question is routinely ignored: how will you pay if you fall ill? In a country where more than 70 per cent of healthcare spending is still out-of-pocket, this may be the most important health resolution of all. Pause for a moment and ask yourself: if you were admitted tomorrow, how long could you pay for treatment before finances, rather than your illness, decide the outcome?

In Nigeria, delayed treatment is rarely about ignorance. People know they should see a doctor. What they lack is the means to do so without catastrophic financial consequences. Studies repeatedly show that many patients arrive at hospitals late—not because symptoms were mild, but because costs were feared. Health financing, therefore, is not a technical policy concept. It is the difference between early care and emergency intervention, between recovery and complications, between dignity and desperation. When healthcare is financed only at the point of illness, it becomes unpredictable, emotionally charged, and financially ruinous. Planning ahead changes that equation.

Most Nigerians pay for healthcare the way they pay for emergencies—when they happen. This practice appears flexible but is dangerously inefficient. Paying out-of-pocket means that treatment is guided by what you can afford, not by what your body actually needs. Patients stop medications midway to stretch costs, preventive care is delayed indefinitely, and families bear the financial shock—often at great personal sacrifice. Ask yourself: have you ever skipped a test, postponed a scan, or refused admission because of money? If so, you are not alone—and that is exactly the problem.

Enrolling in a health insurance scheme can be a lifesaver in more ways than one. Beyond the federal employees’ plan, all 36 states now offer functional health insurance schemes. Private insurance options are also widely available across the country, though generally more expensive and offering broader coverage. True, these health insurance schemes are not perfect, and the range of services covered can be limited—but they provide a vital financial safety net, shielding families from the crushing costs of illness.

Yet, health insurance remains widely misunderstood in Nigeria. Many see it as synonymous with bureaucracy, delayed care, or public-sector inefficiency. Others dismiss it outright, thinking it unnecessary because they “rarely fall sick.” The truth is stark: illness does not schedule itself around your bank balance. Having insurance is not just a policy choice—it is a safeguard against life’s most unpredictable and expensive emergencies.

But insurance is not a guarantee that you will never pay anything. It is a risk-sharing mechanism—a way to spread the cost of illness over time and across many people so no single episode becomes financially devastating. Insurance does not erase pain, but it softens the impact. Even when it is imperfect, it makes a real difference: it allows you to access care without paying upfront, encourages earlier visits to hospitals, makes healthcare costs more predictable, shields against catastrophic bills, and most importantly, replaces panic with planning.

Yet many Nigerians still believe that being healthy today guarantees good health tomorrow. This is a costly misconception. Non-communicable diseases such as hypertension, diabetes, and kidney disease often develop silently. By the time symptoms appear, treatment is rarely cheap, optional, or brief. Health planning, therefore, is not a luxury for the sick—it is a necessity for the healthy who want to protect themselves and their families from financial and medical shocks.

This is where personal health budgeting comes in. You do not need great wealth to plan for your health; you need intention. A personal health budget means setting aside resources— daily, weekly, monthly or annually—for healthcare needs you cannot fully predict but are likely to face. How much you allocate depends on your income and lifestyle, but the principle remains the same: prepare before crisis strikes.

A practical health budget has three layers. The first covers routine care—regular checkups, basic tests, and essential medications. The second ensures prepaid coverage through health insurance or cooperative health schemes. The third is an emergency buffer for costs that fall outside standard coverage, such as referrals or exclusions. Perfection is not required; consistency is what matters. Consider your own situation. Do you have health insurance? When was your last routine checkup? Could you cover a month of treatment without borrowing? Have you discussed healthcare planning with your family? If most answers are “no,” this is not a failure—it is an opportunity to start planning differently.

Scepticism toward health insurance in Nigeria is understandable. Past experiences have left many cautious. But avoiding insurance entirely exposes you to far greater risks. The key question is not whether insurance is flawless, but whether unplanned healthcare costs are manageable. While regulation, transparency, and service delivery must improve, some protection is always better than none. Health financing is ultimately about dignity. Without preparation, illness can strip away autonomy. Choices shrink. People accept substandard care, postpone treatment, or rely on charity. Planning restores agency. It allows patients to ask informed questions, seek second opinions, and focus on recovery instead of fundraising. It protects families from irreversible financial decisions made in moments of fear. In the end, health financing is not just about money—it is about safeguarding dignity when it matters most.

Unlike extreme diets or rigid exercise plans, health financing is a resolution that improves life even if you never fall ill. It reduces anxiety, builds resilience, and supports long-term wellbeing. This January, as Nigerians resolve to live healthier lives, it is time to add one more commitment to the list: plan not only how to live well—but how to pay for care when living gets complicated. Because in Nigeria, the cost of being unprepared is often far higher than the cost of planning ahead.