By Kayode Olopade
The Lagos State Health Management Agency (LASHMA) has announced sweeping reforms to the Lagos State Health Scheme aimed at curbing abuse of the health insurance programme while broadening access to emergency healthcare, rural medical services, and digital health consultations across the state.
The new policy measures, which will take effect from August 1, 2026, are designed to address the growing challenge of "seasonal enrollment"—a trend in which residents enroll in the state health insurance scheme only when they require costly medical procedures and subsequently discontinue their participation after receiving treatment.
Speaking at the second-quarter media parley of the Lagos State Health Scheme held at The Good Shepherd House, Alausa, Ikeja, the Permanent Secretary of LASHMA, Dr. Emmanuella Zamba, described the practice as a major threat to the sustainability of social health insurance.
According to her, the agency has observed an increasing number of residents registering for the ILERA EKO health insurance programme shortly before undergoing expensive medical procedures that would otherwise require substantial out-of-pocket payments.
"We have observed with concern that many citizens only register for the Lagos State Health Scheme a few months before they need to access specific, expensive medical procedures which would otherwise cost them fortunes out-of-pocket," Zamba said.
She noted that many beneficiaries exit the scheme after receiving treatment, only to return when confronted with another costly health challenge.
"After enjoying these comprehensive ILERA EKO services, these individuals leave the scheme, only returning when they face another costly medical intervention. This attitude is highly unhealthy for the long-term sustainability of social health insurance," she said.
Zamba explained that the forthcoming policy review is specifically targeted at discouraging opportunistic participation while protecting vulnerable residents, including those who genuinely cannot afford health insurance premiums and beneficiaries utilizing the agency's flexible "Pay-Small-Small" payment option.
She stressed that achieving Universal Health Coverage (UHC) requires the commitment and collaboration of government, healthcare providers, and residents alike.
"Universal Health Coverage is a continuous journey that requires the collective responsibility of all stakeholders in Lagos State," she said.
The Permanent Secretary also unveiled the agency's operational scorecard, highlighting key achievements recorded under the ILERA EKO scheme and the state's healthcare financing framework since inception.
She emphasized the importance of reliable data in sustaining social health insurance programmes, noting that transparency and accountability remain critical to the success of healthcare financing initiatives.
"Accurate and accessible data is the primary key to the sustainability of any social health scheme. The published figures demonstrate how Lagos State has successfully provided affordable and quality healthcare to millions of residents while maintaining structural accountability," she stated.
On emergency healthcare interventions, Zamba disclosed that the agency's Lagos State Health Management Agency Assistance in Distress (LASHMA-AID) initiative and the Emergency Service Programme had already yielded positive results.
She recalled that the LASHMA-AID initiative was launched on December 18, 2025, in line with an Executive Order, while the Emergency Service Programme commenced in March 2026 to support vulnerable residents and active ILERA EKO enrollees.
According to her, the interventions have saved 18 lives within a few months of operation.
"We are pleased to report that these emergency interventions have successfully saved 18 lives within just a few months of active operations," she said.
Zamba further reviewed progress in the enforcement of mandatory health insurance across the Lagos State Public Service, revealing that enforcement began on February 1, 2026, following the inauguration of a dedicated enforcement team by the Head of Service, Mr. Olabode Agoro.
She noted that while compliance levels among ministries, departments, and agencies have been encouraging, the agency has intensified sensitisation and pre-enforcement activities within the informal sector.
As part of efforts to extend healthcare access to underserved communities, the Permanent Secretary highlighted the recent launch of the EKO Social Health Alliance (EKOSHA) Rural Health Scheme in Agboyi Ori-Omi, located within the Agboyi-Ketu Local Council Development Area.
She explained that the initiative was established to ensure residents of communities without functional primary healthcare centres can access quality healthcare services through mobile medical infrastructure.
"In line with our mantra, 'ILERA EKO, Leaving No One Behind,' we recently launched the EKOSHA Rural Health Scheme to ensure that residents in underserved communities without functional primary healthcare centres can still access quality medical services through mobile health infrastructure," she said.
Zamba added that the agency has also entered into a strategic partnership aimed at extending healthcare services to riverine communities facing geographical barriers to conventional healthcare delivery.
In a move to strengthen collaboration with the media, she disclosed that 72 health journalists, alongside their spouses and dependants, had been enrolled in the Lagos State Health Scheme free of charge for one year.
"The taste of the pudding is in the eating. We encourage enrolled journalists to access healthcare services whenever necessary and provide honest feedback that can help improve service delivery," she said.
The Permanent Secretary also urged residents to take advantage of the agency's telemedicine platform, which provides round-the-clock access to healthcare professionals.
According to her, enrollees can consult medical practitioners 24 hours daily through audio or video calls in Yoruba, English, Igbo, Hausa, and Pidgin, while receiving prescriptions, diagnostic requests, and referrals directly on their mobile phones at no additional cost.
The Lagos State Health Scheme remains one of the flagship healthcare initiatives of the Lagos State Government, designed to advance Universal Health Coverage by ensuring that all residents, regardless of income level, have access to affordable, quality, and equitable healthcare services.
No comments:
Post a Comment