Workers shall oppose any attempt to disband NHIF
NHIF headquarters in Nairobi.
What you need to know:
- The fund has since been struggling to meet its obligations to workers.
- Workers have lost millions due to a lack of accountability.
President Moi left us with a functioning healthcare system and an effective education system. It is sad that over the years, these two most important institutions in our society have been downgraded to deplorable levels.
In 2012, while representing workers in the National Hospital Insurance Fund board, I opposed the implementation of the new membership contribution rates because as constituted then, NHIF did not have the capacity to manage such huge funds.
At the time, the then-Cabinet Secretary for Health was all over the NHIF, micro-managing the fund as if it was just a department under the ministry.
Prior to the implementation of the new rates, NHIF did not engage Cotu as the umbrella workers’ body.
In 2013, I made good my threat that I would resign if the government approved the new fees without due diligence and accountable management. Time has, indeed, absolved me. The fund has since been struggling to meet its obligations to workers.
Workers have lost millions due to a lack of accountability. Meant to assist workers to cover their medical expenses, NHIF has over time been converted into a cash cow where politicians exploit the funds for personal use.
Mandate and objectives
Moreover, card-holding NHIF members have been denied services in hospitals because the fund has not been remitting payments to medical facilities.
Recently, the Majority Leader of the National Assembly, Amos Kimunya, introduced the National Hospital Insurance Fund (Amendment) Bill, 2021 to the floor of the House that seeks to not only amend NHIF Act No. 9 of 1998 but also disband, in total, the NHIF as we know it.
Cotu and all its 45 affiliate unions oppose the amendments as contained in the NHIF bill. Here’s why.
NHIF was established by workers and formalised under Cap 255 of the Laws of Kenya in 1966 as a department in the Ministry of Health to provide insurance for those in formal employment. Therefore, the core mandate of the fund is, and remains, to provide medical insurance cover to all its members (workers with an income) and their declared dependents; spouse and children.
On the contrary, the bill seeks to change NHIF from a fund to a scheme as well as its mandate and objectives. In essence, this bill will disband NHIF and bring up an amorphous body with new objectives. This is against the wishes of Kenyan workers, who are the contributing members of NHIF.
This amendment mirrors the detested Affordable Care Act in the US, which has been disruptive to the health benefits of American workers and failed tremendously in times of Covid-19. Very soon, because of this bill, employers will stop providing health coverage to their staff, just like in the US. On the contrary, NHIF, as it is, mirrors the National Health Service (NHS) in the UK. This is how the UK contained the adverse effects of the Covid-19 pandemic.
Full of ulterior motives
It is without question that the rationale behind the initiators and supporters of this Bill is full of ulterior motives, considering the mandate of the NHIF should not be maximising on the amounts they are collecting but to effectively use the collected amounts. What is it that the Bill wants NHIF to do with the money they are seeking to collect from any Kenyan above the age of 18 years that they have been unable to do with the money contributed by over eight million members?
The Bill also seeks to coerce Kenyans to contribute towards NHIF without assuring them reliable services and transparency. This is wrong.
Additionally, the NHIF management is yet to conduct any proper consultations to get views from both workers and employers as required by Convention 144 of the ILO on social dialogue. Cotu is reliably informed that even the NHIF board did not hold a meeting to discuss the bill.
NHIF should emphasise on accountability of the fund and the effective use of the same. The government should stop any move aimed at interfering with the structure and the objective of NHIF. If the government is in dire need of a scheme to offer universal health to Kenyans, it should create a separate scheme.
Any attempts to disband the NHIF will leave workers under Cotu with no other option but to move to court to seek an order to annul any such move.
Dr Atwoli is the Secretary-General, Central Organisation of Trade Unions (Kenya)
