Medical Services PS Harry Kimutai has urged all Kenyans to register with the new social health insurance schemes once they are in place.
He said they are working on four bills that will set up new funds to replace the National Health Insurance Fund.
Kimutai and his officers met the Senate Committee on Health to discuss four health bills drafted by the Health ministry and which have been submitted to and approved by the Cabinet.
Some of the bills, the Social Health Insurance Bill, 2023, the Primary Health Care Bill, 2023, the Digital Health Bill, 2023, and the Facilities Improvement Financing Bill, 2023 have already been published by the National Assembly.
Two are going to be submitted through the Senate.
He said the Social Health Insurance Bill will set up the Social Health Insurance Fund that will replace the NHIF that has undergone major challenges including lack of funds.
“We want all our community members to be treated no matter the ailment and for this to happen, we all have to have insurance and be registered with the Social Health Insurance Fund,” Kimutai said.
He insisted that all Kenyans must register for the Social Health Insurance Fund as this will enable the fund to run smoothly.
He said the Primary Health Care Bill, 2023 will create the Primary Health Care Fund, which will take care of patients at the lower level hospitals.
The SHIF will take care of all patients at all levels but all Kenyans must register with the fund first.
Another fund, Emergency Critical and Chronic Illness Fund, will then come in to take care of bills that accrue after the exhaustion of one’s SHIF.
This is meant to take care of chronic illnesses and services like cancer, dialysis, among others, which take long and drain finances.
In some cases, the SHIF may cater to, say five rounds of dialysis, but one’s illness may require up to 10 rounds.
“When this happens, we don’t want to go back to our pockets, asking family, relatives and friends to contribute in harambees for our medical bills,” Kimutai said.
He said this is why all Kenyans need to register to increase the pool of funds.
“If we register in huge numbers, the 2.75 per cent that will be deducted from one’s income may even reduce,” Kimutai said.
He noted for now, only a few contribute towards the NHIF and that is why there are problems with funding of hospitals.
“Right now, only a few cater to the treatment of about 80 per cent of the people in Kenya. We want 80 per cent of us to be able to pay. That’s why we are saying every Kenyan must register for Social Health Insurance Fund,” the PS said.
Senate health committee chairperson Senator Jackson Mandago said once the new bills are passed into law, they will replace the NHIF.
“It does not mean that Kenyans will be deducted twice for social health insurance. Those who have been contributing to the NHIF will be transferred to the new scheme,” the Uasin Gishu senator said.
He said the new laws will see the government cater to the vulnerable, who will not be required to pay and will not be penalised for not paying because the government will be paying for them.
“These new bills want to cater for all Kenyans, whether you can pay for it or not. You will be treated when need be wherever you are, even at your nearest possible station,” Mandago said.
However, PS Kimutai said, there will be penalties for non- or late payment of the SHIF.
He said the employer who fails to remit the SHIF money will be penalised at 10 per cent of the contributory money for each employee and those paying for themselves, including businesspeople and farmers, will also pay a penalty for defaulting on payment.
For a family unit, the father or mother’s card can cater to all the children under 18 years of age.
This will also apply to children who are above 18 years but who the parents can prove are still in school and thus have no means of getting an income, according to the PS.
“In the SHIF, once the child gets the birth certificate, they will automatically be under the insurance fund,” Kimutai said.
The PS said Kenyans should not worry about their money not being remitted because they will have a foolproof system that will be in place to ensure the smooth running of the social health insurance scheme.
He said no money will be paid to any health facility under false claims as has been happening.
Today, rogue health facilities make false NHIF claims, being paid for services not rendered or being overpaid for little services rendered.
“There will be Hospital Management Systems linked to the Claims Authority which will ensure at any given time, the authority has data on the number of patients treated at any facility,” Kimutai said.
He said all patients will be uniquely identified by the systems which will be enabled by the Digital Health Bill, 2023.
“We will be able to easily trace one’s records. No hospital will be able to operate without a hospital management system, which will be linked with the claims office.
“We shall be tracking patients and facilities. We will be able to know a particular facility has how many inpatients and outpatients at any given time,” Kimutai said.
This will eliminate the fraud cases where a facility claims to have admitted 30 patients yet its capacity is 15.
“We have learned our lessons through the challenges we have been through with the NHIF. There is going to be a new body. We don’t want to carry the challenges of NHIF into the new body,” the PS said.
