KENYA—Recent stories of how the National Health Insurance Fund (NHIF) has been unable to pay citizens’ claims have been on the rise and Cabinet Secretary (CS) Susan Nakhumicha has admitted that is due to the current government cash crisis.
Nakhumicha admitted this while on an interview with a local Kenyan radio station saying the situation in the country was so bad that the national insurer was still struggling with money.
“Kenya is broke and that is the fact that no one can deny at all. The cash crisis has even affected NHIF and that is the whole truth. We are working on all available interventions to see how we will address the situation,” she said.
The CS claimed that the permanent solution would be the adoption of the Finance Bill 2023.
“I want to assure Kenyans that we sat down with the President this week and informed him about the necessity of the health sector in the country. I told him that he should prioritize the matter and look for funds to pay NHIF. He agreed,” she added.
At the same time, Nakhumicha said the government had formed an advisory council that will seek to address the numerous health workers’ strikes.
“We have gazetted Kenya Advisory Council that will seek to advise how to deal with health workers in the counties and the national government. In the next two weeks President Ruto will inaugurate members of the Kenya Human Resource Advisory Council,” she said.
With the current stalemate kidney failure patients are set to suffer the most as on average a single dialysis session costs between US$64.67 to about US$107.79.
However, with NHIF coverage patients don’t pay anything unless they exceed the three required sessions per week.
NHIF is truly cash strapped
The national scheme currently owes nearly US$ 14 million to healthcare facilities revealed CS Nakhumicha and that she had asked the National Treasury to expedite the payment.
Most of the private hospitals have already withdrawn NHIF and are now asking patients to either pay cash or seek services elsewhere.
Patients who depend on the national insurer to cater for their hospital bills will be forced to pay cash or stay without treatment after this revelation.
Chairman of Rural Private Hospitals Association Brian (RUPHA) Lishenga said, “We took the oath to attend to the patients. It is our duty to do this, but the situation is not good at all. We have been unable to pay salaries for close to three months now and no one seems to listen to us.”
Under the current agreement, the insurer is supposed to pay health facilities for a beneficiary of the national scheme a capitation of US$7.14 per beneficiary per annum within the first 30 days of the capitated period.
Additionally, Lishenga noted that no money had been remitted to RUPHA despite numerous letters of assurance from the NHIF board.
National Assembly Health Committee chairperson Robert Pukose, who is also Endebess member of parliament has given NHIF seven days to pay outstanding bills owed to health providers or the Fund boss be summoned to explain the delays.
NHIF also missed out on US$28 million in premiums after 80 percent of members drawn from the informal sector defaulted on monthly contributions, posing a sustainability threat to the public insurer reported Kenbright Actuarial & Financial Services in April.
The rising defaults came in the period the number of NHIF claims rose from 297,730 to 332,194 while the value of inpatient claims shot up to Sh16.22 billion from Sh14.19 billion.
A presidential pledge- a new NHIF?
President William Ruto while campaigning said that his government would prioritize NHIF to make health care affordable for all.
During Labour Day celebrations, President Ruto announced that the government had changed the contribution formula and that those paying US$3.59 will part with US$2.16 every month.
While his and other high-net-worth individuals’ contributions to the fund would increase from US$12.22 to US$192.61.
“Everyone one of us is going to contribute 2.7% of their earning to NHIF so that we can carry this load of health equally,” Ruto declared.
However, stakeholders have rejected the proposals, including Kenya Medical Practitioners Pharmacists and Dentists Union (KMPDU).
Secretary General Davji Atellah said the president cannot claim to increase NHIF funds by raising deductions from workers by up to 2.75% of gross salaries yet the government slashed NHIF funding.
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