Panelists exchanged greetings at the Workshop.

The workshop started at 10 am with a welcome address by the Chairman, of the Insurance and Pensions Committee of the Section on Business Law Nigerian Bar Association, Mr. Kamar Raji He welcomed guests present and laid a foundation on the reason for the workshop. He promised the audience that the Workshop was going to be educative and informative as well. He was emphatic that the Workshop would also help us to discover the strengths, weaknesses, and purposes of the new Act. In conclusion he also referred to the WHO publication of 2013 where the Organisation argued for Universal Health Insurance Coverage around the world, especially in developing countries. In the publication, the WHO argued that for a country to meet Universal Health Insurance Coverage the following three questions need to be answered:
1. Who is covered?
2. What services are covered (and at what level of quality)?
3. How much financial protection do citizens have when accessing services?

The Chairman of the Nigerian Bar Association Section on Business Law (NBA SBL), Dr. Adeoye Adefulu, thereafter gave his Opening Remarks. He stated that this new legislation is aimed at achieving Universal Healthcare Coverage in Nigeria by encouraging a robust insurance framework and by seeking to make up for the inconsistencies of the repealed the National Health Insurance Scheme Act 2004. He said it is not enough to mandate a law. He said he was eager to know how the National Health Insurance Authority Act (NHIA Act) will achieve its mandate, especially among the informal populace of society and what the Act intends to do to facilitate the business environment. He further stated that the workshop promises to positively impact and influence the lives of members of the NBA. The Chairman also brought a goodwill message from the NBA President, Y.C Maikyau (SAN).

During the programme, the representatives of the President of NBA, Mr. Adesina Adegbite, the General Secretary of NBA and Ms. Chinyere Obasi, The Welfare Secretary walked in. Mr. Adegbite apologized for the absence of the President and for coming late for the event which he attributed to the peculiar Lagos traffic situation of the day and the fact that he had a cold fever overnight which, initially, made him hesitate in coming to the event. Nonetheless, he emphasized the need for health insurance coverage and the effort of the National Secretariat of the NBA towards ensuring that members of the noble body are 2 covered. He promised that the new National Executive of the NBA has keyed into the initiative of the immediate past Executive Council, i.e. towards ensuring that more and more members of the NBA subscribe to the Insurance Scheme. He praised the Council of the SBL for organizing the Workshop which was the first to be held under the new administration of the NBA as well as the SBL. He pledged the support of the national executive council to SBL, which he stated the President and the entire National Executive Council of NBA, hold dearly. 

The representative of the Commissioner for Health Lagos State, Dr. Olamide Okunlaja delivered his speech on the theme: WHERE WE ARE AND WHY A NEW LEGAL REGIME/REFORM. He stated that he was delighted that professionals other than medical practitioners are interested in the business of health and that the health business should be a business of every Nigerian. He pointed out, succinctly, that the NHIA Act 2022 introduced some innovations and makes health insurance mandatory for every Nigerian citizen as against the repealed law which was not mandatory and that the purpose of the new Act is to provide free and basic medical care for all Nigerians.

Dr. Okunlaja also pointed out that if the insurance scheme did not happen through the traditional taxation system like the NHS in Britain and some Western countries, it would happen through other systems. He stated that Nigeria has a great need for health sector reform, because of the inadequacies in our health care sector and how this had caused several deaths which could have been avoidable. He pointed out that it is important for us to see the healthcare as a business and something that should be paid for by eradicating the narrative of free medical services. He was emphatic that there is no successful free health service government programme anywhere in the world. Besides, he stated that someone has to pay for it, either through government funding (extracted from taxpayers) or through direct out of pocket expenses or through the generosity of a third-party donor. A series of questions and answers followed which was exciting and interactive. Subsequently, Mr. Tokunboh Ajibulu, a member of the Insurance and Pensions Committee, reviewed the Act. In his review, Mr. Ajibulu pointed out that it is worthy of note that the new Act mandates Health Insurance Coverage on all Nigerians. He then asked a rhetorical question,“What does a basic minimum package entail?” He further said that the repealed National Health Insurance Scheme Act, 2004 was based on the United Nations Millennium Development Goals which only encouraged members to ensure health insurance on working population. He stated that the new Act is however based on the Sustainable Development Goals of the United Nations which emphasized the universal and compulsory health insurance coverage on all citizens of a member country. He pointed out a weakness in the Act which related to lack of definition of “an indigent person” which if left to the discretion of the NHIA, may lead to abuse. He therefore advised the NHIA to include thee representative of SBL in the committee that will be responsible for the drafting of the operational guidelines, as provided under the Act.

Mr. Olufemi Akingbade stated that the Federal Government has done something laudable towards ensuring that all Nigerians have access to medical attention through the universal medical insurance coverage policy and that it is a step in the right direction as many countries created the Insurance Policy especially in Europe after the 2nd world war. Though Nigeria is starting late but it is better to be late than never. He also said the Federal Government, through the National Health Insurance Authority, will regulate the insurance policies being offered by Health Maintenance Organizations, Mutual Associations (HMO) and other third-party providers, as stated in the new Act. Dr. Adeleke Oshunniyi, in his contribution said government owned hospitals as well as private hospitals are in tune with the universal health insurance coverage policy. He also said that in case a subscriber’s healthcare need goes above the basic minimum package provided by the new Act, all the person needs to do is top up the existing package with a choice HMO which would be able to provide supplemental but comprehensive insurance coverage. Dr. Oshunniyi also pointed out that if the primary healthcare is attended to in an early stage there would be little or no need for the curative healthcare. Furthermore, he said, ignorance is the widest and most common ailment he has encountered as a medical practitioner because patients wait until they are at the verge of death before reaching out to a doctor. Mr. Kamar Raji, asked how would those people who have their physical bodies in Lagos state but their souls in Ogun state a neighboring state to Lagos benefit from the Insurance scheme? Mr. Tosin Awosika also commented on domesticating the new NHIA Act by the individual state of the federation. He stated that contiguous states must cooperate and collaborate to cater for the health care of their various citizens who commute inter-state on daily basis. He assured that Lagos State is currently exploring the angle of cooperation om this basis, with its Ogun State Government counterpart, specially to cater for the health needs of the residents in Ogun State but who work in Lagos State. The moderator also asked a question on the involvement and the inclusion of foreigners on health insurance scheme since the new Act makes the insurance coverage on all residents, compulsory, regardless of the length of stay.

Dr. Femi Olugbile, in reaction, said that foreigners should be made to pay travel insurance premium, as one of the conditions towards issuing Nigerian Visa. He stated that the adoption of this idea by the Immigration Service would add to the money available to fund the Universal Coverage envisioned in the new Act because most of the foreigners may not even use up the Insurance before returning to their home country. The workshop indeed was very informative just as the NBA-SBL Chairman promised. All the panelists and speakers did justice to all questions put to them. In due course, we hope to see how effective the implementation of matters bordering the new NHIA Act would impact on the Nigerian society, socially and economically. 

The event was well attended by members of the NBA-SBL, Lawyers, Sector Regulators and Insurance Practitioners. The workshop was facilitated by a highly distinguished faculty of Speakers and Facilitators which included:

1. Mr. Adesina Adegbite, General Secretary, NBA
2. Dr. Adeoye Adefulu, Chairman, NBA-SBL
3. Dr. Fatai Kayode Lawal, Managing Director, Sterling Assurance Nigeria Company Limited
4. Dr. Emmanuella Zamba, General Manager/Secretary, Lagos State Health Management Agency
5. Dr. Abiola Ajayi, Group Medical Director, ROA Medical Hospital Complex
6. Dr. Olamide Okulaja of the Lagos State Ministry of Health
7. Prof. Mohammed Sambo, Director-General, National Health Insurance Authority
8. Mr. Kamar Raji, Chair, NBA-SBL Insurance & Pensions Committee
9. Dr. Kayode Adesola, President, ANPMP
10. Dr. Leke Oshunniyi, Chairman, Health and Managed Care Association of Nigeria (HMCAN).
11. Dr Femi Olugbile, Senior Consultant, Synthesiz Consultants.
12. Dr. Ola Brown, Founder, Flying Doctors Nigeria.
13. Dr. Tosin Awosika, Lagos State Health Management Agency (LASHMA)