National Hospital Insurance Fund negotiations should prioritise access to healthcare

Insurance has always been a hard sell for many Kenyans. Market penetration remains low and only one in every forty Kenyans has insurance whether personally or as part of a group scheme.

Kenya's 51 insurance companies have always found these odds difficult to crack with half a dozen insurance companies and underwriters going under in the last six years alone.

The National Hospital Insurance Fund, NHIF is the public insurance facility that ensures all members of the public have an access to affordable healthcare.

For workers in the formal sector, membership is compulsory and those in informal sector have an opt-in policy where membership is voluntary.

Currently employers through the umbrella body the Federation of Kenya Employers, FKE are in negotiations with the NHIF concerning an increase made on NHIF payments which the later considered too high.

The new proposal states that formal sector workers earning a gross salary of Sh100, 000 and above should pay Sh1, 700 monthly up from the current Sh320. Those who are self-employed have a separate band where they will start paying Sh500 per month.

NHIF states that the move to raise members' contributions was necessitated by the rise in inflation, increase in cost of medical services and the need to provide comprehensive healthcare solutions.

FKE on the other hand states that the new rates are high and that NHIF has not demonstrated its ability to effectively administrate a larger fund in light of past corruption allegations.

In the center of the two arguments lies the workers who have been forgotten despite the fact that they ideally the direct target of a new and revamped public healthcare system.

The need to overhaul Kenya's healthcare sector is irrefutable. Healthcare in the country continues to be predominantly financed by private sector sources including households' out-of-pocket (OOP) spending.

More worrying is the fact that over the last decade, private sector's share of total healthcare expenditure has decreased from a high of 54 per cent to 37 per cent while public sector financing has remained constant at about 29 per cent.

This basically means that Kenyans are increasingly relying on donor funding and patient out of pocket spending to bridge this deficit.

Low income earners and poor patients have had to suffer most from this arrangement as they have been forced to dig deeper into their pockets to meet healthcare costs.

The situation is made worse by the deprived conditions that are suffered upon many public hospitals in the country. Lack of enough drugs, personnel and equipment has become synonymous with public hospitals throughout the country.

This creates a system where those who can afford private healthcare pay high premium fees to access healthcare while those who can't fall into poverty traps whenever they fall ill.

The government and the private should find a middle-ground and ensure that vulnerable people in society particularly those who are unemployed have access to affordable healthcare.

For the country to cut its reliance on donor funding for crucial campaigns against diseases like malaria, HIV/AIDS and TB, some sacrifices might be necessary and workers, employers and healthcare service providers should approach negotiations with an open mind.