The headache of health­care for all

The East African - - NEWS -

Pres­i­dent Uhuru Keny­atta has cho­sen free univer­sal health­care to write his legacy. “Over the next five years, my ad­min­is­tra­tion will tar­get 100 per cent health­care cover­age for house­holds,” the Pres­i­dent said dur­ing his in­au­gu­ra­tion.

His pre­de­ces­sor Mwai Kibaki had made a sim­i­lar pledge in 2002, but de­clined to as­sent to a Bill that would have brought the dream to real­ity, after in­ten­sive lob­by­ing by the pri­vate in­sur­ers, who feared los­ing busi­ness.

The Pres­i­dent said he would be work­ing to re­form the coun­try’s pri­vate in­sur­ance sec­tor in ac­tu­al­is­ing the pledge.

Tom Gichuhi, As­so­ci­a­tion of Kenya In­sur­ers (AKI) chief ex­ec­u­tive, wel­comed the Pres­i­dent’s pledge, but noted that they needed to see the de­tails.

“We are wait­ing to hear more, be­cause this is prob­a­bly some­thing that has to go through the leg­isla­tive process,” Mr Gichuhi said.

He added that the sec­tor is not op­posed to univer­sal health­care, as it is a pri­mary re­spon­si­bil­ity of the govern­ment and there will still be role of the pri­vate in­sur­ers in cater­ing for needs out­side those cov­ered by Na­tional Hospi­tal In­sur­ance Fund (NHIF).

The Pres­i­dent hopes to use NHIF to drive this agenda, with a prom­ise of in­creas­ing its mem­ber­ship to 13 mil­lion Kenyans from the cur­rent 6.8 mil­lion within the next five years.

“This vi­sion will be driven by a re­con­fig­u­ra­tion of the Na­tional Hospi­tal In­sur­ance Fund and re­form of the laws gov­ern­ing pri­vate in­sur­ance com­pa­nies,” said Mr Keny­atta.

The de­ci­sion to use NHIF may prove prob­lem­atic, given the public im­age of the in­sti­tu­tion, which is as­so­ci­ated with in­ef­fi­ciency and cor­rup­tion by many.

Un­der the 2004 Bill by then min­is­ter of health and cur­rent Ki­tui gov­er­nor Char­ity Ngilu, NHIF was to be re­placed by Na­tional So­cial Health In­sur­ance Fund, which was to be funded by donors, a por­tion of value added tax and mem­ber con­tri­bu­tions.

NHIF has re­cently come un­der sharp fo­cus after its pro­posal to cap the num­ber of out­pa­tient vis­its to four in an year, a move that would af­fect the poor and most vul­ner­a­ble in the com­mu­nity. Public out­cry saw the govern­ment sus­pend the plan, which could be re­vived un­der the new pro­gramme. Fund­ing of the project will be tricky, given the grow­ing fis­cal deficit that the govern­ment is fac­ing.

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