Commit to universal healthcare

Meetings on universal health coverage (UHC) in Kenya have become just talk shows with little improvement to the standard and cost of healthcare.

UHC is becoming another roadside issue for politicians to pull out when they have little else to say. But it needs to be taken much more seriously than it is. Seeing national treasures publicly humiliated for lack of hospital fees is shameful. These are pillars of society who should be comfortable financially and enjoy better healthcare in their winter years as a ‘thank you’ note from the country they served diligently.

The number of people still held against their will in hospitals for failure to pay medical bills is worrying. Public hospitals, which should be a lifeline for poor Kenyans, are not immune from turning wards into prisons for those who cannot foot their bill. Withholding bodies and detaining patients has been deemed illegal; why are hospitals not punished for it?

Holding harambees for those with clout, such as the late Catherine Kasavuli, and waiving fees for Leonard Mambo Mbotela, both legends of broadcasting in Kenya does not help. It is, in fact, discriminatory for patients with no voice or influence. As the high and mighty contributed to Kasavuli’s hospital bill, a mother whose conjoined twins died at the same Kenyatta National Hospital was held captive for failure to pay a Sh3 million-plus bill.

Double tragedy

A mother who suffered the double tragedy of losing her twins should be the last person made to endure further pain of looking for money to rescue herself from a hospital ‘prison’. I cannot imagine this poor woman’s pain. I bet there are many more like her needing to be rescued from the clutches of heartless hospitals.

Hospitals should be the last place one suffers indignity, both as a patient or deceased. Many bodies are yet to be buried because families are unable to retrieve them without first settling the hospital bill. Care and compassion have been replaced by greed at both the private and public health facilities in Kenya. Doctors have become ambulance chasers for money than to save lives and dignify those lost.

Healthcare in Kenya suffers a class problem more than anything else, where politicians and anybody else with a government office are offered better healthcare than the other taxpayers. No politicians would say they truly care about UHC when, using taxpayers’ money, they have carved a better health cover for themselves than that of the voters. No politician would say they care about UHC when they know nothing about the suffering of patients in public hospitals due to poor funding and facilities.

Issue executive order

If politicians cared about patients and ordinary citizens, why has no president ever issued an executive order for public and state officials to use government hospitals and scrap private healthcare for them? UHC will only have meaning if those purportedly tasked to grow it lead by example and use public hospitals. Politicians cannot drain money out of the healthcare budget for their private medicare and then purport to care about poor voters in public hospitals.

The biggest challenge for many families is out-of-pocket hospital fees. They are excruciatingly high and drive families further into poverty. The government must show commitment in creating a UHC programme fit for the prince and the pauper.

The class-based model does not work and is putting many lives at risk in public hospitals, which are starved of funding. We do not need stadiums either; priority should be building a better and affordable healthcare system to keep the nation healthy. The economy cannot be built by patients tied to hospital beds but a free and healthy human resource.

We must have a national dialogue on the type of healthcare system that is fit for all and how institutions such as the National Health Insurance Fund (NHIF) can help in driving that agenda. Saying NHIF is corrupt and doing little to clean it up reeks of complicity.  Kenya is choosing who deserves to live or who does not through a tiered healthcare system. Having insurance for some citizens and not others, even if they work for the government, is not the solution. Neither is waiving fees for a select few or holding harambees for one or two people worthy of politicians’ attention.

If the government is serious about UHC, then it must show commitment. This is important to instil dignity, care and compassion into the public health sector, in particular. Above all, we must take politics out of UHC; it should never be an election campaign tool.

The government should look for ways to fund healthcare for all from one pot, regardless of class or creed. It must also increase the healthcare budget and show how best all the citizens can pay into the pot. We must prioritise better healthcare for all than the brick-and-mortar only mooted by corrupt people as cash cows.

UHC is about better healthcare for all.

Ms Guyo is a legal researcher. [email protected]. @kdiguyo