In a landmark decision underscoring its dedication to quality and affordable healthcare, the Lagos State Government has taken a significant step forward. Governor Babajide Sanwo-Olu has signed a comprehensive Health Insurance Executive Order, a move that promises to transform the accessibility of healthcare services across the state. This bold initiative reflects the government’s unwavering commitment to ensuring that every resident has access to essential medical care without financial burden.
On July 16, 2024, a landmark directive was unveiled, poised to revolutionize the healthcare landscape. This visionary initiative brings together the Ministry of Health, the Lagos State Health Management Agency, and private sector partners in an unprecedented collaboration. The focus is on expanding health insurance to enhance social protection, aiming to create a more inclusive and resilient healthcare system for all.
During a recent press briefing, Lagos State’s Commissioner for Health, Prof. Akin Abayomi, unveiled a groundbreaking health policy designed to revolutionize healthcare access in the state. Prof. Abayomi highlighted the policy’s mission to dramatically enhance health outcomes for all Lagosians by introducing a comprehensive well-regulated, and sustainable health insurance scheme. This initiative aims to create a more equitable healthcare system that leaves no resident behind, ensuring that everyone in Lagos has access to quality health services.
The initiative directly supports the goals of the National Health Insurance Authority Act 2022, which mandates state-level social health insurance as a key step toward achieving Universal Health Coverage (UHC). By making health insurance compulsory at the state level, this effort strengthens the framework needed to ensure that all citizens have access to essential health services without financial hardship.
Social health insurance, universally practised in various forms, has numerous socioeconomic benefits. It pools contributory funds and spreads risk across a large group, minimizing individual financial exposure and enhancing protection. Such schemes provide social safety nets with equitable components aimed at achieving Universal Health Coverage (UHC). Social Health Insurance schemes are typicallymandatory to ensure wide coverage, maximizing collective benefits to society. Contributory premiums are modest, supporting the government in providing a standard level of care to all citizens regardless of socioeconomic status. The Lagos State Social Health Insurance Scheme is called Ilera Eko, which is managed by the Lagos State Health Management Agency (LASHMA). Conversely, private health insurance is typically voluntary, private sector driven, competitive, and profit-driven, offering a wide range of services based on affordability. By creating synergies between social and private health insurance pathways, Lagos is promoting a platform for widespread uptake and sustainable healthcare coverage.
Universal Health Coverage (UHC) ensures that everyone in a region has equitable access to essential healthcare services without financial hardship.
Key characteristics of UHC include a comprehensive range of services covering the common needs of the community, such as preventive care, diagnostics, treatments, and medications. Services not covered by the basic health package of Social Health Insurance (Ilera Eko) can be supplemented by approved private health insurance packages or state-supported medical assistance programmes.
The Executive Order signed by Mr Governor outlines several critical components aimed at revolutionizing healthcare delivery in Lagos State. These components are designed to ensure comprehensive, equitable, and sustainable health coverage for all residents:
1. Promotion of Health Insurance: The government will launch an extensive campaign to encourage the culture of adopting health insurance as a social and economic necessity. This campaign aims to educate the public about the benefits of health insurance, highlighting its role in protecting individuals from high out-of-pocket expenses and reducing the risk of financial ruin due to unexpected illnesses.
2. Enforcement Grace Period: Following a six-month period of intensive public sensitization, the government will begin to enforce the health insurance mandate. The public will be encouraged to access enrollment in either the Lagos State Social Health Insurance scheme (Ilera Eko) or an equivalent State approved and accredited private health insurance plan that includes the bouquet of services contained in Ilera Eko. This removes the complexity of duplication of enrollments in two schemes to be compliant with the Executive Order and the NHIA law.
3. Public-Private Synergy: The initiative seeks to create a harmonious relationship between the government’s Social Health Insurance scheme (Ilera Eko) and private sector health insurance systems. By leveraging additional resources and expertise of Health Maintenance Organizations (HMOs), the government aims to expand and improve access of comprehensive health protection to all citizens, ensuring that everyone is covered by at least a basic level of social health protection, reducing administrative costs and simplifying processes.
4. Technical Working Group: The implementation of mandatory Social Health Insurance Scheme will be overseen by a dedicated Technical Working Group (TWG)within the Lagos State Ministry of Health. This group will include executives from the Lagos State Health Management Agency (LASHMA), experienced professionals, consultants and key stakeholders from both the public and private sectors. Their responsibilities will include overseeing the blended health insurance scheme, ensuring it operates efficiently, meets its objectives, and maintains high standards of service delivery. Through the TWG, the Lagos State Ministry of Health would release shortly an operational guideline that would determine the interplay and relationship between the Social health Insurance Scheme and the Health Maintenance Organizations as mandated by Mr. Governor through the Executive Order.
5. Funding for the Vulnerable: The collaboration between government and private sector stakeholders will result in an expanded pool of funds. This will enable the government to provide social health insurance to an even larger number of vulnerable residents in the State. Additionally, this component addresses the challenge of funding emergency medical care for unidentified patients in urgent need of life-saving interventions.
6. Regulation and Oversight: The government will step up its regulatory role, ensuring both social and private sector health protection schemes operate effectively, therebyimproving the experience of Lagos residents.
7. Quality Assurance and Monitoring: Regulatory oversight to ensure a higher standard of healthcare service delivery will be heightened by our Health Facility Monitoring and Accreditation Agency (HEFAMAA). Healthcare providers participating in the scheme will be expected to meet these standards to be enrolled into the scheme as providers of healthcare services.
Abayomi said, “No Lagosian should have to choose between healthcare and other basic needs. This scheme is designed to eliminate those barriers and ensure everyone can receive the care they require, when they require it.”
He called on healthcare providers, civil society organizations, the private sector, and the public to join in this transformative journey. “We are building a healthcare system that serves everyone, and we need the support of all stakeholders to make it a reality”, Abayomi said.
The Commissioner expressed deep gratitude to Governor Sanwo-Olu, praising his visionary leadership and unwavering dedication to the health and well-being of Lagos State residents. He stated, “Governor Sanwo-Olu’s bold vision and steadfast commitment to healthcare reform are truly commendable. His decision to issue this Executive Order reflects his unwavering determination to ensure that every resident in Lagos State has access to quality healthcare.
With steadfast resolve, the goal is clear: every resident of Lagos State will have access to quality healthcare. The commitment is unwavering, ensuring that no one is left behind in the pursuit of well-being. Through tireless efforts and an unyielding dedication, the vision is to build a healthier Lagos where top-notch healthcare is not just a privilege, but a guaranteed right for all.
Signed
Tunbosun Ogunbanwo
Director, Public Affairs
13th August, 2024
