MORAL HAZARD AND NATIONAL HEALTH INSURANCE SCHEME PENETRATION IN LAGOS, NIGERIA

This study investigated how moral hazard may constrain the strategic intent of National Health Insurance (NHIS) in promoting access to more effective health care financing. Life expectancy and healthy life expectancy of Nigerians is currently estimated to be below 50 years-a far cry from other countries development index. As at 2015, only five million persons (about three per cent of the population) have enrolled in the NHIS. The degree of penetration of NHIS may have been significantly moderated by the indirect influence of ex-ante moral hazard arising from several factors which may include standards of medical and hospital cares, and exclusions available in the scheme. A survey was carried among out-patients in the two Teaching Hospitals in Lagos State. Using ordinary least square techniques, the study found disincentives to participate based on the scope of exclusions and opaqueness of health services which induces moral hazard of mass non-participation. A review of the exclusion list and operational efficiency of the Health Management Organizations are recommended plus increased public expenditure to improve standard of health care. Contingent claims on social security may also be used to reduce health care burden of chronic diseases.