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November 17, 2018

KIBISU KABATESI: Who's funding Uhurucare?

" The National Hospital Insurance Fund already provides subsidised medical insurance to all salaried employees."
" The National Hospital Insurance Fund already provides subsidised medical insurance to all salaried employees."

The fad in town is Universal Healthcare.

President Uhuru Kenyatta latched onto it and made it part of his ever-expanding original Big Four that now includes corruption.

The National Hospital Insurance Fund already provides subsidised medical insurance to all salaried employees.

The NHIF is awash with public money.

If the National Youth Service has taught us anything, it is that when a public entity is constipated with billions, corruption comes knocking.

That aside, the NHIF cover is very discriminatory.

Other than the highest contributor subsidising the lowest, government has cut deals with high-end health providers to cater for only certain mainstream cadre and senior civil servants.

The majority career civil servants and those in public service in general whose outfits have not contracted independent health schemes, despite contributions to the NHIF, are condemned to the vulgar indignity of ill-equipped and poorly supplied county health facilities.

Though county-run health facilities have taken on the NHIF scheme with gusto, they are unable to offer comprehensive medical treatment as speculated in NHIF brochures other than prescriptions to buy drugs from private pharmacies in their neighbourhood.

One such, Mama Lucy Kibaki Hospital run by the Nairobi government, felt embarrassed enough to call in bulldozers to raze the chemists.

There is also the glaring lack of value for money when the highest contributor, at Sh1,700, for instance county government employees, cannot access high-end hospitals for lack of secondary subsidised top-up contracts by counties with these hospitals.

Even then, there are cost caps while the chosen few have a roller-coaster cover with no inhibitions as to costs.

The Sh1,700 contributor is not just subsidising colleagues in the public service; they’re actually funding UhuruCare optics.

First, those on voluntary or self-employed surrender only Sh500 to access equal if not better service depending on location, capacity and rating status of a health facility.

Second, since 2015, with funding from the World Bank, the Health ministry through NHIF has been experimenting on providing comprehensive services to 21,000 senior citizens, orphans, persons with disability and the vulnerable.

The programme recruited 181,000 by June and though the WB has closed its coffers, the ministry proposes to scale up the experiment under UhuruCare to cover ‘all vulnerable households’ plus 360,000 elderly under a Sh2 billion NHIF scheme called Supa-Cover. There is clearly obfuscation over the ‘vulnerable’ and ‘households’; the former donates numerable individuals while the latter is limitless numbers.

Where will government source Sh2 billion in these hard times, when Kenya is back-peddling on a Sh5.5 trillion debt and Kenyans can’t afford anymore ‘sin tax’ invasion of their near-empty pockets?

Just how many ‘vulnerables’ are there in need of comprehensive medical cover? What are the criteria for vetting them? The economy isn’t creating jobs anymore; who then is expected to fund this mischievous outing other than already exhausted contributors?

Counties too have caught the UhuruCare bug and are hustling past the NHIF to ape Makueni and Kitui in providing comprehensive healthcare. What isn’t clear is whether there isn’t duplication between UhuruCare and, for instance, Governor Charity Ngilu’s seductive Kitui County Health Insurance Cover (K-Chic) in targeting ‘vulnerable’ beneficiaries.

 

Given health is devolved, one wonders where is the confluence between Supa-Cover, and K-Chic and Governor Kivutha Kibwana’s Makueni ‘free service’. Assuming Kibwana and Ngilu success depend on circumventing the NHIF, isn’t that enough evidence UhuruCare is destined to fail?

 

Supa-Cover will have no charge. In Kitui, a household pays Sh1,000 while Makueni is Sh500 annually for a free ride into futuristic state-of-the-art health facilities. Are we building castles in the air? We need a reality check. Two outcomes are possible: a free UhuruCare Supa-Cover will doom Kibwana’s innovation or despair will send hordes from a deceptive Supa-Cover into under-capacity county hospitals. 

 

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