One of the lengthiest posts you will read from me on Prof Usman Yusuf and his travails at the NHIS. The drama surrounding NHIS head, Professor Usman Yusuf is one that should have garnered much more attention and scrutiny than it has had so far. In typical social media sensationalism, people were more concerned about the literal and metaphorical interpretation of ‘hyenas and leopards’ than with the high stakes power tussle within a health agency that is of greater direct relevance to 180m Nigerians. I had a few disparate thoughts and views on the issue given that I am more interested than your typical casual observer in issues related to public health and on top of that I tend to poke my nose every now and then into issues relating to governance and policy. My thoughts, in no particular order hovered around: 1) False equivalence: There are two sides to every story. However, that does not mean that the two sides of that story have equal veracity, urgency and consequence. Professor Usman went on a whistle blowing tour screaming weighty accusations of outright fraud to the tune of hundreds of billions of naira over 12 years (N352 billion by some accounts) before a ‘counter accusation’ surfaced accusing the Prof of misappropriating N300 million. I did a simple arithmetic in my mind and 300 million is less than 0.1 percent of N352 billion, so why was there more outrage, more media coverage and more attention (at least in the initial stages) to the one percent alleged fraud over 2 years and not 100 percent fraud over 12 years? If you owned a personal business and had to face a 352billion vs a 0.3 billion theft, which one would you prioritize? 2) Copy and paste: I watched a number of interviews and presentations by Prof Yusuf and the most quotable phrase coming out his multitude of public statements and interviews was “Do not copy if you do not know how to paste.” By that turn of phrase the Prof went to describe how we could not properly copy the HMO model from the United States. This is where we need to take a step back and educate ourselves: NHIS was conceived as a platform that will form the bedrock of a national health financing model that will cover *all* 180 million Nigerians. I know this will be breaking news to most in Nigeria, but our current model where you are required (and harrassed) to pay for health care services when you are sick and in need of treatment is considered an absolute failure. For more than a century all developed nations and most emerging economies have evolved a system whereby citizens pre-pay for health services mostly through some kind of taxation or voluntary registration with very little if any out-of-pocket payment required at the point of service. This system ensures affordability for the citizenry and a stable budget for health services among other advantages. Back to copy and paste. Back in our school days we had different ‘classes’ of copy-copy. We have smart copy-copy who know to copy answers intelligently while changing some words and style from the original answer. Then we have those who are not so smart but can copy exact replicas from that ‘smart student’ verbatim including typographical errors. But the worst copiers are the olodos that copy the wrong answer to the wrong question and even copy the other person’s exam number. In one instance, I once met one such olodo that wrote “Please turn over” in the middle of the page! What does that olodo copy-copy guy have to do with NHIS, one might ask? Picture the person whose task was to copy and paste a formula for NHIS. That person went to the country with the world’s largest economy and highest health expenditure but was ranked a paltry number 37 on the WHO ranking of health systems. Despite the huge US economy, health care accounted for about 17% of GDP (by far the most expensive worldwide) and has been rising exponentially leading to unending political battles about how to fix their health system. That copy-copy person(s) could not copy the health system of Singapore that stood at respectable No. 6 in the world while costing only 3.9% of GDP. Why couldn’t our copy-master even go ahed and copy from France, the world number one or UK that is ranked 16 places higher than US despite spending only 9% of their GDP on health care? Indeed our copy-master dubbed the wrong system from the wrong country and even that did not copy correctly! 3. The war on corruption needs to carefully handle retaliation. If we want to fight corruption and protect the citizens right to know, we must ensure those government officials that come forth with alleged whistle blowing are offered some protection against backlash and reprisals of entrenched corrupt interests. Protecting whistle blowers is in our overall common interest, otherwise we would be sending the signal that any one who speaks up are on their own. It is unrealistic to expect a whistle-blower not to be taken seriously because that may person has committed or is alleged to have commited some unwholesome practices in the past (Hon. Abdulmumin Jibrin comes to mind). If we are to encourage whistle blowers, we should offer them some form of temporary protection from counter-prosecution, punishment or suspension of any sort until the case which they brought forward has been duly investigated and prosecuted by the courts. Because if the court or a relevant commission of inquiry confirms the N352 fraud for example, then Prof would have grounds to claim he was being targeted as retaliation for whistle blowing. Most whistle-blowing laws in countries we copy-copy from protect against such retaliation. 4. Prof is fighting multiple demons with a lot of bravado but limited strategy. In my view, Prof started a war with entrenched interests without taking time to build and nurture alliances within and outside his organization. He has not effectively created an awareness of what NHIS is and what it was meant to provide to the average Nigerian. A lot of Federal civil servants, whose salaries were deducted to finance the scams he alleged would have been reliable allies if they had understood what was at stake. Besides, to make things right, we need a proper national conversation and consultation regarding how we want to improve the health status of Nigerians. 5. APC’s image as an anti-corruption party has almost turned into an oxymoron.