Mass medical health insurance enrolment will curb mind drain —HMO MD

The Managing Director and Chief Govt Officer of Final Well being, a Well being Upkeep Organisation, Lekan Ewenla, on this interview with OLASUNKANMI AKINLOTAN, explains the advantages inherent in medical health insurance, the challenges affecting the accelerated enrolment within the programme, and options for the way the sub-sector can change the narrative of the nation’s poor well being indices

How will medical health insurance enhance entry to well being care in Nigeria?

Throughout the globe, significantly within the developed world the place medical health insurance was made obligatory a number of years in the past, everybody has unhindered entry to outlined, high quality healthcare providers. As soon as you’re enrolled in a medical health insurance programme, you’re free to stroll into a selected facility to entry the care that’s outlined for you. It is very important point out that 80 per cent of healthcare providers are accessed on the main degree. The thought of introducing medical health insurance in Nigeria was to make healthcare inexpensive, accessible, and equitable. Globally, folks can’t afford to pay out of pocket. Healthcare is just not low cost; it’s fairly costly. That’s the reason the medical health insurance idea is designed to cross-subsidise the medical wants of the poor and the sick with these of the wealthy and the wholesome. The thought behind the introduction of medical health insurance in Nigeria is to alter the narrative of our poor well being indices by guaranteeing that folks have unhindered entry to high quality care. When you enrol, protection lasts for 12 calendar months.

What have been the foremost landmarks within the medical health insurance sub-sector in 2025?

The most important landmark this 12 months, in 2025, was the pronouncement by Mr President on the necessity for all excellent ministries, departments and businesses of the Federal Authorities to right away enrol their staff within the public sector medical health insurance programme. The Secretary to the Government of the Federation issued a round on the 14th of September 2025 to all MDAs and different important stakeholders, clarifying that Federal Authorities ministries and businesses are mandated to enrol their workforce within the public sector medical health insurance programme. I need to make clear that the mandate was particularly focused on the income-generating federal establishments which have, through the years, enrolled their employees in personal medical health insurance programmes as an alternative of the general public sector social medical health insurance programme.

The issuance of the round in September was a really important achievement for the nation and the medical health insurance sector as a result of the invoice to make medical health insurance obligatory was handed into regulation in 2022. I need to reiterate that it has been a significant problem for us, the important stakeholders, to embark on the strategic enrolment of Nigerians on this medical health insurance programme as per the regulation. This was due largely to an absence of respect for the regulation of the land by Nigerians. The mandate of Mr President was to drive dwelling that time.

What different organisations are affected by the federal government’s directive?

It is very important shortly add that the mandate was not restricted to the Federal MDAs, because it was additionally prolonged to the organised personal sector; each employer of labour also needs to endeavour to enrol their workforce in a medical health insurance programme and thereafter request a certificates of compliance from the Nationwide Well being Insurance coverage Authority for affirmation and document functions. With that directive, personal corporations are anticipated to enrol their workforce by means of their appointed well being upkeep organisation, and the HMO thereafter formally requests a Compliance Certificates on behalf of the corporate.

It would curiosity you to know that the regulation particularly states that each employer of labour with a minimal of 5 staff ought to enrol its staff in a medical health insurance programme. What which means is that it’s the accountability of the employer of labour on this class and above to pay a medical allowance together with the employees wage and primarily convert that medical allowance right into a medical health insurance premium for your entire employees. That is obligatory for all employees.

Medical insurance gained’t drain staff’ pockets…

As I’ve simply stated, it’s the accountability of each employer of labour to maintain the medical wants of their workforce. Employers will not be doing their workforce a favour by enrolling them in medical health insurance. The regulation specifies that after you’re an employer of labour with a workforce of 5 or extra, you’re anticipated to pay a medical allowance. Enrolment in medical health insurance is principally the conversion of the medical allowance right into a medical health insurance premium on your workforce. It doesn’t translate to employers of labour having to borrow funds to pay for medical health insurance. It’s no matter is being paid to the person employee as a medical allowance that’s meant to be transformed into the medical health insurance premium for her or him. It’s not going to create a gap in any employer’s pocket.

What are the opposite advantages of medical health insurance?

It can result in an accelerated transformation of our healthcare infrastructure, as premium funds from hundreds of thousands of Nigerians will translate to the supply of multi-trillion naira within the healthcare trade. It will robotically translate to large funding within the sector. The rationale Nigerian medical doctors and nurses are leaving the nation for different nations is just not due to something aside from the truth that these international locations they will launched obligatory medical health insurance a very long time in the past, and it’s working. It has equally enhanced the take-home pay of each employee in that sector. The identical factor might be achieved right here if all of us determine to take the bull by the horns. That’s what we’re doing right here.

What are the hindrances to the expansion of medical health insurance in Nigeria?

Essentially the most outstanding problem that has been affecting the deepening of the enrolment course of in Nigeria is top-of-mind consciousness. The extent of consciousness is low. The Federal Ministry of Well being, someday in August, organised a programme in Abuja tagged “Re-emerging Well being Care Financing in Nigeria”. All important stakeholders have been current. A part of the challenges that got here up prominently was the necessity for the regulatory company, the NHIA, and different important stakeholders, like Well being Upkeep Organisations, to embark on strategic media campaigns that may create top-of-mind consciousness for Nigerians. The advantages of the medical health insurance programme are huge. When folks get to grasp the advantages that they stand to take pleasure in, they may start to ask for the enrolment course of.

It would curiosity Nigerians to notice that there’s a blueprint for the way Nigeria can attain Common Well being Protection, developed by Nigerians within the nation and within the diaspora. The title of the doc is “One Nation, One Well being”. In that doc, all of the 36 states of the federation and the Federal Capital Territory are anticipated to undertake a uniform primary plan for all Nigerians. That doc additionally recognized 83 million Nigerians as weak and really helpful that two per cent of the Federal Authorities’s consolidated income be earmarked to supply primary healthcare providers for the weak. When you’ve got ever heard concerning the Fundamental Well being Care Provision Fund for the Weak, that’s the programme. The common primary plan is designed for all Nigerians to have entry to the identical high quality and amount of healthcare throughout the 36 states and the Federal Capital Territory. As a matter of reality, the personal medical health insurance programmes that almost all of the organised personal corporations and the income-generating federal businesses enrol their workforce in are known as Complementary or Supplementary Healthcare packages. This interprets to the truth that each Nigerian is anticipated to be enrolled within the Fundamental Healthcare bundle.

Essentially, a part of the technique of the Federal Authorities was to utilise the enrolment within the programme to develop a unified database for the nation. That’s the reason all people who’s being registered within the medical health insurance programme is anticipated to supply his or her Nationwide Identification Quantity as a part of the information required for registration.

Having stated that, a very powerful factor we’re lacking now could be the necessity for all of the state medical health insurance businesses, by means of the governors of the states, to grasp the truth that no matter they’re driving on the state degree, there’s a want for all of us to return to the drafting board shortly and take a look at the adoption, introduction, and implementation of the essential plan in all of the states of the federation. It’s when that is completed that we are able to start to noticeably drive the expansion of medical health insurance.

One other main problem we have now is the truth that the organised personal sector began embracing medical health insurance by shopping for personal medical health insurance merchandise from well being upkeep organisations through the years. That was not the appropriate method to driving medical health insurance in Nigeria. As we communicate immediately, the vast majority of the organised personal sector, the vast majority of personal people, and the vast majority of Small and Medium Scale Enterprises can’t afford personal medical health insurance merchandise. If we go by what the regulation says, enrolment on the essential plan is mostly inexpensive. The essential plan could be very wealthy in content material. What which means is that everyone now wants to return to the drafting board and start to enrol their workforce within the primary plan. It’s while you enrol your workforce within the primary plan on the state degree, on the OPS degree, and on the SME degree, that anyone who’s keen can then enrol in a supplementary or complementary plan. Below the brand new regulation, and to recalibrate the operational means of the programme, the regulator is now anticipated to approve and code all of the supplementary or complementary merchandise of the HMOs earlier than they’re offered to members of the organised personal sector.

Moreover, you will need to make clear that medical health insurance is well being danger administration and is totally different from healthcare providers.

There’s this false impression or misinterpretation of medical health insurance as healthcare providers. Medical insurance is principally pooling the well being dangers of individuals collectively and offering these providers which are outlined for them at an agreed quantity or premium per particular person, every year. Healthcare service, then again, is the method of accessing care in an outlined facility at a tariff fastened by the service supplier.

Whereas healthcare is on the concurrent listing in our structure, medical health insurance is on the unique listing. The regulator for the programme is the NHIA. It is just the NHIA that may regulate it. No state authorities can regulate it.