What you need to know:
- A low-income person falling seriously ill in a county like Kisumu where public health workers are forever on strike will be very lucky to survive
If you think the Sh500 monthly fee the government is asking for towards its planned mandatory health cover scheme is expensive, try shopping for private medical insurance.
The products the local insurance companies are currently marketing as affordable would still set you back some Sh300,000 in a year or Sh25,000 a month for a family of four.
The government’s latest efforts to make healthcare really affordable to all Kenyans through its Universal Health Care (UHC) programme should be supported.
But for the programme to be successful, the authorities need to be sure they are in touch with the reality of poverty in the country.
Two years ago, I became increasingly concerned about the health of some two close relatives and their households back in the village. If any of them were to fall seriously ill and require hospitalisation, where would they get the money for huge medical bills?
After much agonising, I arrived at the decision to help them enrol on the National Hospital Insurance Fund (NHIF) – under its plan for non-formal workers and the self-employed that requires a member to pay Sh500 monthly. We agreed I would pay for the first three months then they would take over. The paperwork presented quite some headache because four of the children in one household didn’t have birth certificates, which delayed the enrolment process by about a month.
Worst possible time
Early last year my worst fears were confirmed. One of the household members didn’t only fall ill and require hospitalisation but she also did so at the worst possible time and at the worst possible place.
A low-income person falling seriously ill in a county like Kisumu where public health workers are forever on strike will be very lucky to survive. As is the case now, striking health workers paralysed services at Kisumu’s public hospitals.
Private hospitals were charging an arm and a leg for drip water and bandages as usual, but with an NHIF card I thought my patient could afford one of the low-end facilities. Turned out the card had been deactivated, with the last payment being the one I made the previous year.
I immediately realised my folly. When I came up with this supposedly bright idea, I didn’t give thought to their ability to pay in the long run.
As the government plans to roll out a mandatory health cover, it should give thought to the ability of the majority low-income households to sustain payment of the Sh500 monthly fee.
I understand the Ministry of Health collected some data while piloting the UHC programme in Nyeri, Kisumu, Machakos and Isiolo. But is it sufficiently confident that it now has its finger on the pulse of the health funding challenge?
The NHIF recently announced an amnesty to people whose cards had been deactivated on account of defaults, suggesting the retention of the voluntary members is one of the major problems it is struggling with.