Why SHA is not working- Miskellah

Kenya Medical Practitioners and Dentist Union (KMPDU) Deputy Secretary-General, Dennis Miskellah, says challenges facing the Social Health Authority (SHA) can be resolved by overhauling its current funding model.

According to Miskellah, the government has failed, on multiple instances, to remit deductions from civil servants to the scheme, locking them out of the service while also crippling SHA.

Further, the KMPDU official proposes a deductions plan on products consumed by every Kenyan, akin to the Value Added Tax (VAT), as opposed to salary deductions from the working citizens who account for only twenty percent of the population.

The current framework, he says, is unsustainable.

“80 per cent are in Jua Kali, only 20 per cent are on a salary. Many wait to fall sick to pay which is not the way insurance works. Why can’t we introduce a tax where for everything you buy a percentage goes to healthcare,” questioned Miskellah while on Spice FM on Friday, March 21. 

The medic also believes that the resounding unpopularity of SHA results from its failure in financing primary health care, which is depended on by about 80 percent of Kenyans- contrasting the ten percent who require admissions, and the one percent in critical care.

Dr. Dennis Miskellah: The biggest challenge of SHA is financial problems. If the government allocated the correct amount of money SHA would work.#TheSituationRoom Follow our live conversation on YouTube: https://t.co/1FsYcL4yyN pic.twitter.com/PfzNvG99ir

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SHA uses a means-testing formula to calculate the amount each registered Kenyan needs to contribute depending on their financial strength.

However, this system depends on the accuracy of the data the government has on the person, giving some people the leeway to conceal some information to contribute less.“Kenyans have learnt to beat the system. This means testing cannot work,” said Miskellah.

“We don’t need to be threatened, coerced, or even be massaged by politicians to register for any health scheme. As long as it’s working, they’ll join it.” 

Moreover, Miskellah has questioned the logic behind the multiplicity of funds under SHA, comparing it with the National Health Insurance Fund (NHIF) which had a single fund that served its purpose.

Some of the funds currently managed by the Authority include the Primary Healthcare Fund for outpatient services, the Social Health Insurance Fund where 2.75 per cent salary deductions are made to cover inpatient services, and the Emergency, Chronic, and Critical Illness Fund for financially draining services like cancer care.

All these funds, he says, have continued to receive an almost insignificant fraction of the allocations requested from the government adding to patient suffering.

“Primary Health Care Fund asked for Sh64 billion but was allocated only Sh4 billion. Out of this, they only spent Sh1.35 billion since they didn’t have a system to give it out to. Emergency, Chronic and Critical Illness Fund asked for Sh114 billion and received only Sh2 billion,” he noted. 

SHA would work with the right funding, Miskellah says.