01062019 - APC lawmakers move against party

SATURDAY Vanguard, JUNE 1, 2019—23
Lagos boosts family welfare with
compulsory health insurance
Recently, a group of stakeholders
from the National Institute for
Policy and Strategic Studies, NIPSS, in
collaboration with the Development
Research and Project Centre (DRPC)
through Partnership for Advocacy in Child
and Family Health at Scale
(PACFaH@Scale) carried out a study tour
of health facilities in Lagos State.
They had one agenda—to evolve a
realistic and sustainable funding
arrangement for Universal Healthcare
Coverage.
They visited various institutions and had
interaction with key stakeholders and
heads of strategic institutions including the
Lagos State University Teaching Hospital,
LASUTH, and primary healthcare centres
in Palmgrove, Mushin and Lagos Island.
Their mission was clear and justified. The
Acting Director of Studies at the NIPSS, Dr.
Nasirudeen Usman, who led the
delegation remarked that the focus was on
how Nigeria can evolve the best funding
arrangement that can bring about
universal healthcare coverage in the
country.
It is an established fact that
participants in NIPSS
programmes are expected to
embark on national, continental
and intercontinental study tours
on critical issues to the country’s
development aspirations with a
view to making actionable
recommendations on best
practices.
It is also no secret that
Nigerians have not had it
smoothly in healthcare delivery
over the years particularly at the
primary healthcare level even as
the lack of a reliable referral
system has only complicated
matters.
Technical
advisor,
PACFaH@Scale, Dr. Stanley
Ukpai, said the study tour was
meant to help participants to find
out how to strengthen the
primary healthcare system to
achieve Universal Health
Coverage in the state. Through
the tour, the delegation obtained
useful feedback on challenges
and opportunities within the
primary healthcare system
towards realising the goal of
Universal Health Coverage for
the State.
In the views of Dr. Jide Idris,
technology would be the
stronghold of the scheme to ease
the application process for
enrollees. Idris who was the State
Commissioner for Health,
during the launch of the Scheme
in December 2018 by former
Governor Akinwunmi Ambode,
said a lot of awareness was being
created about enrolling people
into the scheme.
The law setting up the Lagos
health Scheme makes it
compulsory regardless of
financial or educational status.
Already, 120,000 persons have
enrolled, however, full
implementation would
commence as soon as the
bottlenecks are sorted out to
avoid pitfalls of the National
Health Insurance Scheme,
NHIS.
The Lagos State health
Scheme is one of a kind. To
avoid the pitfalls of the NHIS,
the Scheme is mandatory for
every resident in accordance
with global practice.
The Lagos health scheme
aims to provide financial
protection against illnesses
and attendant uncertainties
inherent in out-of-pocket
payment system. Besides
being projected to reduce
health issues or mortality rate
in the state by at least 10 per
cent, Ambode said it will
deliver significant economic
benefits to the state.
“Beyond ensuring a
healthy population, the
scheme will foster inclusion
and an increase in the
utilisation of hospital services,
thereby
creating
employment opportunities
for medical professionals.
This will definitely have an
impact on the economy of the
state,” Ambode stated.
The Scheme is specifically
established to meet the gaps
identified from existing
health insurance Schemes in
the country. The main pillars
of accessibility, equity,
quality and financial
protection were taken into
consideration when it was
being put together.
The Scheme came about
through a law enacted in
2015 that makes health
NHIS:A female Doctor attending to family health need
insurance mandatory for
every resident of the State.
The main objective was to
provide quality healthcare
services which is accessible
and affordable to the
residents of the State and in
so doing, reduce, if not
eliminate the financial
catastrophe that arises from
huge medical bills.
The Scheme covers
common ailments that make
people go to the hospital
and that can actually cause
financial burden.
Currently, what is being
pushed forward is a single
health benefit package plan
that cuts across at a
premium of N40,000 per
annum for a family of six,
The main objective
was to provide
quality healthcare
services which is
accessible and
affordable to the
residents of the
State and in so
doing, reduce, if not
eliminate the
financial
catastrophe that
arises from huge
medical bills
that is, the mother, father
and four children under the
age of 18 years.
Enrolling every additional
family member below 18
years attracts N6,000 per
person per year. However, if
the person is above 18 years,
it attracts additional
premium of N8,500 per
person yearly. For single
individuals, it is for N8, 500
per year, but this can be
upgraded any time after
marriage with additional
charges.
For employees in the state
public service, the state takes
care of 75 per cent of the
premium, while each civil
servant pays 25 per cent.
Obioma Obikeze, a
consultant for DRPC,
expressed concern over the
payment arrangement for
civil servants, stressing that
workers at the lowest rung of
the ladder will be
disadvantaged if every state
employee, irrespective of
status, pays 25 per cent
premium.
“We are also meeting the
key stakeholders in the
informal sector, which
constitutes about 65 percent
of the population because if
you don’t enroll these
people, this Scheme will fail.
We know the informal sector
constitutes a huge chunk of
the population, and that’s
where the real work is.
“We have mapping which
has details of everyone in the
informal sector. Luckily, we
have an agency of
government dealing with
them. We have met with the
various union executives,
and they have expressed
interest. We also need to
continuously reach out to them
through persuasion. Some of
them are already on one scheme
or the other, but whether that
scheme is better or not, it’s a
matter of them knowing what we
are offering,” Idris said.
And for the poor who genuinely
may not be able to afford the
premium, the state said an equity
fund has been set aside to cater
for them by subsidising the
premium 100 percent for the
vulnerable. “That is why the law
establishing it says a minimum of
one percent of the consolidated
revenue fund of the state will go
into a pool, which is an equity
fund basically to address people
who cannot afford to pay. That is
to guarantee a financial
protection for them. The
contribution of the poor will be
paid from that equity fund,” he
explained.
According to the Provost, Lagos
State University College of
Medicine (LASUCOM), Prof
Anthonia Ogbera, the Lagos
State health scheme would take
care of common adult and
childhood ailments, maternal and
child services, preventive
healthcare services, selected noncommunicable
diseases and
surgeries.
The Oba of Lagos, Oba Rilwan
Akiolu, who was part of the
delegation, urged government to
improve budgetary allocation to
the health sector in line with
recommendations of the World
Health Organisation (WHO).
Although the failure of the
National health Insurance
Scheme, NHIS, has been largely
attributed to activities of Health
Management Organisations,
HMOs, Lagos State is still
utilising their services in belief
that they have vital role towards
overall success of the Scheme.
In the views of the Chief
Medical Director, Lagos State
University Teaching Hospital
LASUTH, Prof Adetokunbo
Fabamwo, 10 HMOs are to be
engaged, each assigned its
catchment areas.
“Registration is state-wide and
that is why we decided to allocate
HMOs to certain areas for ease of
capture. If an HMO is said to cover
Mushin for example, they will go
out there and capture all the
citizens of the area into the
scheme because the higher the
enrollees, the higher their
capitation fee.
“If you tell people in Mushin to
look for any HMO and join,
enrolment will be slow. For the
formal sector, we gave them a
choice of HMOs to choose, but for
informal sector, we allocated
HMOs to them so as to achieve
100 percent coverage,” he said.