Universal Health Coverage (UHC) is emerging as a solution to achieving health outcomes for all. Although the mechanism may enable countries to cover promotive, preventive, diagnostic, curative and rehabilitative health services, but it will be equally desirable to establish robust health financing systems to ensure sustainability and effective implementation of UHC. With increasing widespread support for universal access to healthcare, the question of how to fund it effectively and sustainably remains unanswered despite the use of conventional ineffective options of taxation, user fees and insurance as well as the models of innovative financing that are offering promising alternatives. However, experiences have shown that countries that have achieved universal coverage have developed prepayment –tax-based or social health insurance-based (SHI) and reduce the reliance on out-of-pocket payments and user fees.
It is against this context, that the policymakers in Nigeria are asking which way forward. Is innovative financing the answer or do tax-based and social health insurance-based (SHI) still have relevance in promoting the country healthcare coverage? How does the fiscal and macroeconomic context influence decision-making in this policy area? It within this context that the policy makers is attempting to exploring alternative health financing mechanisms – called the “pathways” that have three options termed scenarios – the tax-based, social health insurance and the pluralistic designed to achieve/ensure universal health coverage (UHC) within a reasonable time frame (NHIS/IFC 2013).
In this paper, we use the simulation model to address these questions. The main components of the simulation model “SimIns” (Carrin and James 2008) are presented in the next section. Section 3, examines three alternative scenarios, by forecasting changes in health expenditure and revenue over 14 year period and then compare the alternative scenarios with baseline solution.