Principal
Secretary for Medical Services Ouma Oluga has said that 95 per cent of cancer
patients receiving treatment under the Social Health Authority (SHA) are not
paying anything out of pocket.
Speaking
in an interview with NTV on Wednesday, Oluga acknowledged that five per cent of
cancer patients may still be paying out of pocket, especially when the total
cost exceeds the capped benefit limit.
“From my
estimation, how many of the 48,000 Kenyans currently undergoing cancer
treatment are going to the hospital and going back home without paying a shilling?
95 per cent. These other 5 per cent are the ones who are right now dealing with
cancer and have to pay out of pocket,” he said.
However,
he urged the public to view these as exceptions rather than the norm.
“We do
understand that there may be 10 Kenyans or 20 Kenyans who may have gotten
treatment worth, let us say, Sh700,000. SHA paid up to Sh600,000, but there is
this Sh100,000 that was remaining,” he said.
“We want
to make it very categorical that 99% of Kenyans who walk into a hospital and
get treatment, walk out without having to be asked anything.”
Oluga explained
that although cancer treatment costs vary widely, from as low as Sh200,000 to
as high as Sh10 million, the average cost per patient under SHA is around
Sh600,000.
He said
this figure forms the basis of actuarial models used to determine benefit
packages under the new health financing model.
“Some
cancers you can treat for Sh10 million, some cancers with Sh200,000 you are
good. Now, if you take all the 45,000 Kenyans who have cancer, and you look at
the cost of treating cancer, whether it is Sh10 million or Sh200,000, it will
be Sh600,000,” Oluga said.
He
emphasised that while exceptions exist, they are rare.
According
to him, SHA has already supported five million Kenyans, many of whom underwent
high-cost procedures without paying a single cent.
“Five
million Kenyans have gone into a hospital, gotten treatment and not paid a
single cent because SHA paid for them,” Oluga said.
“There
are Kenyans who have had cardiac surgeries, and SHA paid Sh950,000. Zero
shillings added. Whether it was at Karen Hospital, Nairobi Hospital or Aga Khan
Hospital.”
The PS also
broke down the costs of treating the most common cancers, breast, cervical and
prostate, showing that most treatments fall well below the Sh600,000 average.
“You may
need three things. Number one, surgery costs between Sh120,000 and Sh180,000.
Number two, radiation costs about Sh200,000. Number three, chemotherapy. All of
these have been over a year. That is still within the Sh600,000 mark,” he said.
Oluga
insisted that SHA operates on the principle of equity, adding that even the few
exceptions are not left behind. He said the Authority has set up a call centre,
147, where any Kenyan can lodge concerns.
“Every
individual case is being attended to. SHA is based on the principle of equity.
There is no single Kenyan who has an issue, who raises that issue, that goes
unsorted,” he stated.
“The law
establishes the Benefit Package Advisory Panel which is independent and is now
collecting all those views. Help is here. And the call centre, 147, is active.”
He
acknowledged there are challenges but stressed that treatment for the majority is
accessible and fully funded.
Oluga appealed for public understanding that SHA is a work in progress, but is already delivering tangible results.
