In signing the Primary Health Care Act, 2023, the Digital Health Act, 2023, the Facility Improvement Financing Act, 2023 and the Social Health Insurance Act, 2023 into law, President William Ruto seeks to achieve universal access to affordable healthcare across the country.
The various laws are to streamline government funding for healthcare at different levels, better management of healthcare facilities, and technology adoption for data management in the health sector.
All these are great ideas. It is high time we solved different bottlenecks plaguing the health sector - from financing, to logistics and operations, to training and remuneration of healthcare professionals, to private sector businesses in the industry.
However, as is the case with most policy proposals, the devil will be in the details of implementation. Only time will tell whether the President considers these advancements serious attempts to improve access to healthcare, or if the whole enterprise will go down the same path as other projects launched with fanfare only to die slow and quiet deaths.
With the fear of shoddy implementation in mind, a couple of red flags are worth exploring.
First, it is noteworthy that the note on the State House website touting the new healthcare plan has no single mention of devolution. Every thinking Kenyan adult knows health is the most important devolved function.
How does the new plan fit with county-level primacy over the sector? Is the government intent on re-nationalising the health sector?
Second, the new plan came with a new tax on workers at 2.75 per cent. This raises the question of whether we are increasing taxes to improve access to affordable care, or is the new healthcare plan simply a gimmick to raise revenue for a cash-strapped government facing the risk of debt distress (similar suspicions continue to hang over the president's affordable housing scheme).
Only time will tell us the answer to these questions. Cynicism aside, a successful healthcare system can become an important pillar of our social contract.
As a country, we desperately need a national public sector collective project through which we can demonstrate our can-do spirit and collective competence.
The healthcare and housing plans are prime candidates for this role. One hopes that their successful implementation will not be sacrificed on the altars of debt servicing, general public finance mismanagement, and incompetent cronyism.
-The writer is an Associate Professor at Georgetown University
