Governors propose mandatory health insurance cover

Two governors on Monday proposed that health insurance be made mandatory to all  Kenyans  to help  the country  achieve Universal Health Care.

Kisumu Governor  Anyan'g Nyong'o and his Nyeri counterpart Mutahi Kahiga however noted that the  proposal will require further consultations at the Council of Governors before it can be considered.

Their proposal received backing from the parliamentary health committee acting chairman Martin Owino who said every Kenyan should have a medical insurance cover.

The MP however said that while the suggestion was welcome, the challenge would be how to finance it.

"We need to have a discussion on this issue and when time comes to adopt it, then that should be done gradually and in a way that is less punitive to the people," he said.

The legislator who led the 19-member committee to review the UHC report prepared by the Health ministry after the UHC pilot in four counties, said models for  financing the health insurance for the unemployed and those in the  informal sector must be looked at.

"While it is easier to implement the proposal for the salaried, it is a challenge for the other cadres," he said.

Nyong'o and Kahiga  who spoke  in Kisumu during the launch of a Sh65 million universal health scheme also suggested that counties be allowed to procure drugs directly through competitive bidding  from pharmaceutical companies.

They said the Kenya Medical Supplies Agency was supplying counties with overpriced drugs which is no longer sustainable to the devolved units. 

The governors said the agency was suffering from inept management and should  be reformed immediately. 

The two,  in  whose counties the UHC was piloted in 2018 alongside Machakos and Isiolo, further noted that the woes facing the health sector would easily be fixed if the public hospitals are  made functional as expected.

Nyong'o said counties must deal with the problem of corruption in public hospitals."Why should a pharmacist who is employed in a public hospital be keen on selling drugs meant for the facility  to a pharmacy nearby? It is because of the culture of eating where you work which must be rooted out," he said

He said if corruption was not fought at the facility level then the county governments charged with management of health risk being sabotaged from within their own  systems.

"We must make the public health facilities functional by ensuring they are  efficient, able to  offer quality health care and are soundly managed to attract the public who need the services," he said.

Nyeri governor said there was  need for accountability on the part of doctors to assess whether patient gets value for money.

"Why would our doctors be the ones referring patients to private hospitals where they serve instead of giving quality services to those who need the same in the public facilities where they are employed? "he quipped.

Kahiga who read a statement on behalf of the CoG chairman Martin Wambora said the council was committed to accelerating the attainment of UHC.

"We need to create infrastructure to ensure delivery of health care in our counties. We should also increase and equip lower level hospitals," he said.

The chairman of the committee of eminent persons on Covid-19 appointed to advise LREB counties Kama Rogo for reforms in the management of public health facilities,  financing and human resources recruitment to save the trouble ridden health sector.

He proposed that counties hire consultant doctors on contract basis. "At specialist level, we need to craft new contracting model where specialists doctors  and consultants only  come to see and  review patients," he said.

Rogo noted that  most successful private hospitals do not have consultants working as permanent and pensionable workers. "County governments  should consider this model and it is time to review the employment scheme which are now outdated," he said.

The Marwa Kisumu Solidarity Health Cover which was launched on Monday, is an affordable and accessible medical cover which is targeting 90,000 poor households.

According to Nyong'o,  45,000 households are set to benefit from the scheme in phase one. 

The scheme according to the governor will enable  beneficiaries to access both inpatient and outpatient care under the NHIF Supa Cover benefits package.

He said the package will be  rolled out initially in 48 selected public health facilities across the seven sub-counties. 

However, other resident of Kisumu county not captured in the scheme will self-pay into the Marwa NHIF SUPA Cover by self-enrolling into NHIF to  enjoy the negotiated advantages for those in the Marwa scheme.

This will happen once the  Bill currently before the Kisumu County Assembly sails through.

The cover is aligned with Nyong’o's manifesto to provide all residents of Kisumu with accessible, affordable, quality and timely healthcare. It is anchored in the Kisumu County Health Act, 2019 which also stipulates the implementation of mandatory health insurance for all Kisumu residents.

-Edited by Sarah Kanyara