New social health insurance must be worth the money

Kenyans registered with the defunct National Hospital Insurance Fund were this week automatically migrated to the new Social Health Insurance Fund.

There was a hue and cry as more than 10 million members were on-boarded into the new health insurance scheme. Besides being turned away by several major hospitals due to the confusion in the transition, the new scheme will see Kenyans paying more for the premiums.

Kenyans in formal jobs will pay 2.75 per cent of their gross salary to the new SHIF. Those in the informal sector will also pay 2.75 per cent of their gross income with a minimum of Sh300. This steep increase will see the renamed fund receiving billions of shillings to streamline healthcare.

The much-maligned NHIF also received billions of shillings yearly, but a majority of Kenyans have reservations about its services. Indeed, it is ironic that most Kenyans in corporate organisations rarely use NHIF to access health services, despite paying more in premiums. Instead, they preferred private insurance packages paid for by their employers.

This indifference, perhaps, made NHIF incompetent and lacking in initiative to fix Kenya’s long-running healthcare financing puzzle. NHIF was also hit by numerous corruption scandals where taxpayers lost billions of shillings. Several past NHIF managers have been implicated in procurement scams and money-siphoning schemes.

As this happened, many Kenyans complained of getting no or little financial support from NHIF. Many families have been rendered bankrupt by high hospital bills, while the majority have had to organise fundraisers to offset them.

Does the new SHIF offer a sigh of relief? The Kenya Kwanza government has promised that every Kenyan will get quality healthcare under the new scheme. But already, several major hospitals and clinical officers in smaller facilities have turned away patients who visited without cash. In our view, therefore, it behoves the Ministry of Health and the new Social Health Authority to assure Kenyans of quality services. This includes ensuring that bills are settled promptly to avoid situations similar to what happened in the past where Kenyans were detained by hospitals over medical bills.

High earners will contribute a significant part of their income to SHIF and will demand better services in hospitals than they have done in the past. Will the new scheme finally treat the middle class better this time around? Will the cover be comprehensive and commensurate with the higher premiums?

The new scheme must also guard against fictitious claims that marred the former NHIF, draining huge resources from the scheme. The cartels in the former scheme must be uprooted urgently as the new scheme is rolled out. The bottom line is, that Kenyans deserve better and quality healthcare from the new SHIF!