How Hussein died while begging his insurance to pay up for treatment

The National Hospital Insurance Fund (NHIF) Building ,Nairobi . February 8th,2024.[FILE/Standard] On Monday, The Standard highlighted the emotional story of Abdulahi, not his real name, struggling in hospital with breathing complications as his family ran from hospital to hospital in a bid to save his life. His private insurance and Social Health Insurance Fund (SHIF) cards had been rejected by hospitals as not working despite being active. That desperate man in our story was 52-year-old Hussein Jilo Haro. He is dead. Hussein's family had asked us to conceal his identity, fearing reprisals from his employer, Isiolo County Government, where he worked. But now in death, his family has come out in the open and lifted the veil. Hussein, now six feet under at Isiolo's Tulloroba Muslim Cemetery, died on Tuesday at 11:30am while being transferred to a private facility in Meru for specialised care. He had heart complications that occasioned breathing difficulties, according to his family. His kin say Hussein still clutched close to his chest his wallet bearing two medical cards that he faithfully contributed to and that should have guaranteed him dignity in sickness but instead failed him to death. He left a medical bill of slightly above Sh100,000 at the private hospital that his family is yet to settle. "We had to find a guarantor to stand in for us for them to allow us to pick his remains for burial," said Jilo Buke Said, a relative who sat beside him in the ambulance as medics fought to resuscitate him. "His eyes said it all, he knew time had come. He died a man with a heavy heart. I am still haunted by what I saw. He was utterly beaten, stressed and weighed down by heavy bills and was denied the care he needed, even though he had valid insurance," said Jilo. Hospitals, both public and private, turned him away even when he produced both cards and instead insisted on cash payment. "It's extremely tough to imagine that Hussein is no more. He was a good man who loved people. He would speak about his children so many times. We've lost a decent human," noted Jilo. The Standard recently exposed damning details from the Office of the Controller of Budget (CoB) that revealed a staggering betrayal of public trust in healthcare provision. Despite evidence showing most counties had paid premiums in full, and some partially, thousands of county staff across the country were still locked out and could not access medical services they were entitled to. In Isiolo, where Hussein worked as a ranger in the Ministry of Tourism and Trade. CoB records show that by mid-June this year, the county had wired Sh76 million to its private insurer, against a contract sum of Sh120 million. That's more than half the amount due, and the insurance policy is managed by Transnep Insurance Brokers. We contacted Isiolo County Government officials for comment, but they did not answer our phone calls. Some insurance experts now call it one of the most clinical forms of theft in broad daylight, affecting several county staff. "Insurance is a cash-and-carry business. Premiums are always paid upfront before services begin. So why can't county staff get treatment?" wondered Alex Githae, an insurance expert who calls it a violation of law and logic. "We produced Hussein's medical card when we took him to different hospitals, but they told us it stopped working long ago. Where are we going to get money to pay these bills? Why are the cards not working when he hasn't even exhausted them?" his younger brother wondered. The Kenya Healthcare Federation (KHF), which represents the entire private healthcare ecosystem, has sounded a warning that all civil servants, including county staff seeking care in private hospitals, will be forced to pay out of pocket. KHF has put the Social Health Authority (SHA) on the spotlight for failing to clear claims running into millions of shillings accumulated for the past nine months. In a letter seen by The Standard and addressed to SHA CEO Mercy Mwangangi, KHF chairman Dr Kanyenje Gakombe says hospitals are struggling financially. Currently, the government owes hospitals Sh33 billion, both private, public and faith-based, in addition to Sh32 billion under SHA.

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