NHIF bill reeks of mischief, needs review

The National Hospital Insurance Fund (NHIF) Amendment Bill 2021 continues to raise weighty questions. Instructively, it aims at converting the fund into a scheme to cover all Kenyans in form of universal health coverage (UHC) after enlisting all citizens aged 18 and above, who will pay Sh6,000 per year in premiums.

There is no harm in the country’s quest to plan for citizens’ health. But there are all reasons to reject such a plan if it is not logically viable.

NHIF is said to have about 11 million members, only half of whom are active. Granted, there is no way the scheme will be guaranteed regular premiums from those it aims to forcibly enlist, given that even voluntary subscribers have had difficulties in honouring their monthly contributions.

The minimum target age of 18 is largely composed of youngsters still in the care of their parents. Is this a subtle way of forcing parents to pay for their ‘overage’ children, most of whom are in college, if not jobless, yet most of them can’t cater for their subsistence?

The government also plans a similar free medical cover for 10 million poor households. How many people are we talking about here? Suppose a poor household averages five persons (most have four, national statistics show), doesn’t that make 50 million, hence the national population?

And assuming that the figure is lower, what criteria will be employed to identify the beneficiaries? Already, there are questions about the beneficiaries of the Inua Jamii cash transfer and the Kenya Covid-19 Fund.

Poorly thought out

But the worst part of the bill targets employers, who would be required to match their employee’s monthly contribution. For instance, Teachers Service Commission will pay NHIF about Sh4 billion per year, assuming that it contributes an average of Sh1,000 monthly for its 340,000 employees. The pain will be similar for other employers, who could retaliate by pulling out of private medical cover for their workers in favour of a doubtful scheme.

Whereas NHIF needs more money to roll out UHC, it hasn’t demonstrated prudent use of the ‘little’ they collect. Claims of fraud involving conspiracy between its staff and hospitals abound, yet we haven’t witnessed any serious prosecutions.

And the proposed scheme, despite the double collections it’ll squeeze out of formal employees, would only be accessed once the member has depleted their private medical cover. I foresee inconveniences here.

Ideally, the bill has good intentions, but which are poorly thought out. Its drafters must review it. Governments are only trusted for one thing: Tax collection. It will, therefore, not be surprising to see the draft law sail through Parliament unopposed so that the government can collect more money from an overtaxed citizenry, never mind its usage.

Healthcare is our constitutional right. The government shouldn’t run away from its responsibility — worst of all, kill those who have tried to guarantee such a right, as exemplified by the various private medical covers provided by some employers.

Mr Osabwa is a lecturer at Alupe University College, Busia. [email protected].