Lagos state health management agency bill has been signed into law

Lagos State Health Management Agency Bill which will mandate Lagosians to have compulsory health insurance was signed to law on Monday 25th of May 2015 by The governor of Lagos state, Babatunde Raji Fashola. The Lagos State Health Management Agency Bill and the Lagos State Health Scheme signed to law, means that there is an agency that will manage the Lagos State Health Scheme which is to be governed by a board with a chairman and other ten members. Also included for appointment is a General Manager to be the accounting officer for the agency.

The bill is pro-poor in nature recognizing that the poor and vulnerable will need to have subsidized premiums from the state government. The Nigeria Health in Africa program believes that this act by the Lagos state government signposts a sure way of improving health outcomes in Lagos and ensuring that the poor have access to quality healthcare.

In the bill, other citizens are mandated to contribute into the Lagos Health Fund regardless of whether they consume care or not( e.g. well to do citizens must contribute even where they have coverage from overseas plans). 

The aim is to run a Lagos state health scheme that will be made mandatory for all residents of Lagos state. It recognises that in existence are prepaid health care agencies already being subscribed to by residents of Lagos state but the minimum anyone can have is a plan under the Lagos state healthcare. It is compulsory and the Lagos state registration agency card will be the least perquisite for anybody to be registered under the scheme.

According to a medical practitioner who prefers to remain anonymous, “The Ministry of health in Lagos state is already creating guidelines and working with some partners in looking at the benefit package for the scheme and also the best way of implementation. Firstly, members of the board will still have to be selected and then we will look at the implementation strategies. Because there is already going to be a transition period from the incumbent to the incoming, it is after the transition that the bill will be implemented”

“Also, the members of the board must be approved by the Lagos senate especially the chairman of the board not only by the governor but the house of assembly. The process will go through the normal procedure of short listing and approval.” She said.

According to the governor of Lagos state, Babatunde Raji Fashola, “For those who cannot afford the scheme, Lagos state is not saying there is no free health anymore, but we know that there are things that are covered under the free health like malaria treatment and antenatal…for those things that are not covered by the health scheme and cannot be afforded by the less privileged, it will be paid for. Such individuals will be recognised and identified and they will be paid for by the government from a fund to be created that will come from the Federal, state levels and development partners.”

For Wale Alabi, a medical practitioner “Lagos state is always a pacesetter in development projects for such and no other state has done this not even at the Federal level and it is an opportunity for private healthcare providers to develop their own enterprise. It is also an avenue of economic growth for Lagos state, providers can now provide services knowing that they will be paid for those services. It is also an avenue for residents of Lagos state to have access to quality healthcare not only from public facilities but also from private facilities.” He stated.

Lagos state despite being the smallest state in Nigeria is believed to be the most populous state in Nigeria (20 million based on estimates from the Lagos state bureau of Statistics in 2012).  Whilst Lagos has enjoyed strong economic growth its performance has not been particularly stellar in health outcomes, it has been implementing a not too successful ‘Free health care program’ since 1999 under the manifesto of the previous party (but same government). The new party does not have free health on its manifesto but health insurance. It is also instructive to note that Lagos despite its rapid population growth experienced the fastest poverty reduction in Nigeria with a drop in poverty rate from 57% in 2004 to 23% in 2010.    

Olumide Okunola, Senior Health Specialist, IFC l World Bank, on the latest signing of Lagos State Health Management Agency Bill says “Recall that the Nigeria NHIS has been stuck at less than 5million lives since 2005 as it has been unable to manoeuvre through the complex maze of political economy of Universal Health Coverage issues in Nigeria. This strong reform is transformative as it is innovative and with this Lagos is once again well on the way to blaze the trail in making quality and affordable health care to all residents of Lagos which most states hopefully will learn from.” He revealed.

Importantly, the agency may decide to use the health insurance organisations to be the intermediary between the providers and the agency so when the scheme starts running, the HMOs will come in. The bill will start running later this year though the process is ongoing.

Kemi Ajumobi