Replacing NHIF not a solution

‘Private hospitals in Kenya are greedy for money.’ That was the opening line in my article of February 21, 2022 in this newspaper. The title of the article was, ‘Divorce NHIF from Private Hospitals.’

My argument then and now is that private hospitals in Kenya don’t have any interest in patient care but profit. They are too expensive for most Kenyans, and until recently became prisons for patients that could not afford to clear their fees.

Most importantly, private hospitals are just another route for embezzlement of public funds. The government failed to heed the advice and is now out lamenting just a year later about billions of shillings being fraudulently paid to private hospitals. I can now say, I told you so!

Private hospitals are private entities that should never be funded using public funds in any shape or form. The money now claimed to have been stolen from the NHIF by private hospitals could easily have helped to improve the standard of care in the public hospitals which have been wanting since indepedence.

I say so, because, Kenya enjoyed better health facilities last when the colonial government was still around. Most of the hospitals built pre-independence are still standing. Those built later by post-independence government were built for kick backs. They are just brick and motor and nothing to show for inside worth to save lives.

The recent gas explosion in Embakasi is the very reason why robust public health facilities are important in order to deal with emergencies. The state of healthcare in Kenya will not be changed by changing the structure of the NHIF. If it ain’t broke why fix it? The focus in the changes have been all about raising money and little effort seems to go into plugging the loopholes that have led to NHIF leaking billions of shillings into the hands of private healthcare operators. No new system will be enough to deal with the rot at the heart of the health sector.

The government may be hellbent in renaming NHIF and failing in telling the country how it intends to hold to account those that have scammed NHIF. The shift from NHIF has the potential of creating a situation where those implicated in the theft of money from NHIF not held culpable for the crime.

What would happen to the NHIF thieves and the monies lost once Kenya moves to the new health insurance system? Would the new body carry such liabilities along or it is set up in order to let the thieves go scot-free?

Private hospitals are private entities and should be raising their revenue from patients willing to pay from their own pockets or via private health insurance. No public funds should be used to prop up private hospitals locally or abroad.

No public funds should either be used to pay for private insurance for public workers. The insurance scam involving the teachers by a private insurance company should be a lesson for the government. If money was not lost to all the avenues being created to embezzle funds from NHIF such as private hospitals, there should be enough money to build public health care facilities fit for presidents and paupers.

The formation of a new health insurance for the public is premature and suspicious. NHIF is killed before it has even lived. There is nothing wrong with NHIF structure to demand for its replacement and even then at a speed of God. The current government has barely drawn breath before it tore down NHIF. It is important to have continuity on how public health is managed for patients’ sake and enhance accountability.

The Embakasi gas explosion won’t be the first emergency involving hundreds of people. It is therefore important to build healthcare facilities that are able to cope should there be even bigger emergency in the future involving hundreds and thousands of people. Stability in institutions such as the NHIF is important in being able to achieve universal health. That stability will not be achieved by ill-thought out policies that would derail its ethos.

I therefore believe there is no justification to alter the NHIF. Contributions could still be changed and managed under NHIF as long as the intention is to make universal health accessible to all.

There is nothing in a name if management of health insurance for the public will still be mired by corruption and poor management. The government should therefore focus in building the NHIF and protecting it from losing money to unscrupulous private hospitals and corrupt officials. UK’s national health service has provided healthcare to the public for 75 years and counting. Why should NHIF not have the same longevity if not for corruption? Let NHIF live on. Instead sever ties with private hospitals. That would close one avenue for corruption affecting NHIF. Retaining it will also help in recovery of billions already stolen from NHIF which could then be ploughed back to improve public health facilities.

NHIF is publicly funded and should only benefit public health facilities.

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