By Adesina Wahab

Managing Director and Chief Executive Officer of Ultimate Health Management Services, Otunba Lekan Ewenla, has commended the Bola Tinubu administration for increasing the health insurance premium for the public sector social health insurance which translated to significant increment in the capitation fees and the fee-for-service for the health risk management on the program.

The CEO, in a statement on Thursday also lauded the recent Federal Government’s directive on the enforcement of enrolment of all Federal Ministries, Department and Agencies and the Private Employers of labor on the mandatory health insurance program. 

He described the development as a bold and commendable step toward achieving universal health coverage and improving Nigerians’ overall well-being.

According to a circular issued by the Office of the Secretary to the Government of the Federation (SGF), MDAs were mandated to ensure immediate compliance with the new health insurance policy.

The circular stated that the order followed President Bola Ahmed Tinubu’s approval of measures to strengthen the National Health Sector Renewal Investment Initiative (NHSRII) launched in December 2023.

It noted that the President directed all MDAs to ensure the enrolment of their employees in the NHIA plan, and that a valid NHIA-issued Health Insurance Certificate would henceforth be part of the eligibility criteria for all entities participating in public procurement processes.

The directive was copied to senior government officials and institutions, including the Chief of Staff to the President, Head of the Civil Service of the Federation, all Ministers, Service Chiefs, Inspector-General of Police, Governor of the Central Bank of Nigeria, Permanent Secretaries, and Chief Executives of Parastatals, and Agencies of Government.

Reacting to the circular in an interview, Ewenla said the Federal Government’s decision to enforce mandatory health insurance was long overdue and crucial to fixing the health system’s persistent challenges.

Ewenla said the policy would help the government build a unified database for citizens while ensuring sustainable access to healthcare for every Nigerian worker.

According to him, the integration of the National Health Insurance Scheme with the National Identity Management Commission (NIMC) database is a major milestone that will enhance planning, service delivery, and accountability in the health sector.

He said: “The idea behind this mandatory health insurance program is to ensure that everyone is registered with their proper identity, since the database is now synchronized with NIMC. Many Nigerians and private companies may not be aware of this, but it is important that we all begin to comply with the law so that we can be seen as developing accordingly. 

“If there is anything affecting the systematic development of our economy, it is the poor regard for our laws. The reason why systematic development is seen in other parts of the world is because of recognition and respect for rule of law. The government has taken the bull by the horns by mandating every employer of labor to enroll their workforce on the health insurance,” he said.

Ewenla observed that one of the major challenges slowing Nigeria’s growth has been poor regard for laws and regulations. He urged both public MDAs and the private employers to see the new directive as an opportunity to strengthen the nation’s health system and support the government’s reform agenda.

He further noted that compliance certificates issued to employers would indicate the exact number of staff enrolled, to prevent manipulation and ensure transparency.

Ewenla stressed that Nigeria’s poor health indices, medical tourism, and mass migration of doctors abroad are largely due to poor commitment to compliance directive to the mandatory health insurance program.

According to him, “If we achieve just 30 per cent coverage on the health insurance, the volume of inflow into the health sector will be enormous which will enhance our health infrastructure and bring back Nigerian doctors and nurses.

He added that in countries where Nigerian doctors currently work, the health system thrives because health insurance is mandatory, creating predictable funding for the sector.

Ewenla appealed to all employers of labor to comply with the NHIA directive and ensure their staff are enrolled with accredited HMOs, including both the basic and the  supplementary plans.

He clarified that implementing the directive should not create financial strain for organizations, as the premium can be covered by converting employees’ existing medical allowance to health insurance premium.

“The concept of health insurance is simple. The basic plan provides the minimum required care for everyone, while employers who wish to provide more extensive coverage can subscribe to supplementary packages.

The Ultimate Health boss called on the government to introduce a clear framework and timeline for compliance, stressing that enforcement mechanisms such as linking health insurance certificates to procurement and licensing processes would encourage adherence / compliance private companies and the operators in the informal sector where we have the bulk of Nigerians.

He explained that the certificates would be renewable annually, like driver’s licenses or vehicle insurance, to ensure continuity and regular updates.

He explained that under the NHIA structure, 65 per cent of the premium is remitted to the primary healthcare as the risk manager, while certain percentage is paid to the HMOs as risk managers at the secondary and tertiary levels as the risk managers.

He noted that the biggest challenge affecting the provision of qualitative services on the program remains the thinly spreading of enrollees across several primary facilities which completely eroded the actuarial recommendation of 2,500 enrollees as benchmark.