Everyone needs insurance

Dr Patrick Gatonga has worked at UAP-OLD Mutual, as well as McKinsey’s Africa Office as a Senior Consultant. Prior to that, he was a Health Systems Development and Program Management Specialist for UNICEF and AMREF Health Africa. He holds a Master’s

Degree in Business Administration, a Bachelor of Medicine and Surgery degree (MBChB), and a Bachelor of Science in Human Anatomy.

What is medical business?

I look after the health business of Jubilee Health Insurance by owning the strategy for the business and the clients. In a country of almost 50 million, only about 1.5 million people are insured. This is on the extreme low, so a lot more needs to be done to get more people insured. When people do not have health insurance, it results in a financial catastrophe at the family level whenever someone falls sick and accrues huge bills. My role entails figuring out how to seal this gap.

What drew you to this aspect of medicine?

My mother suffered from rheumatoid heart disease. Although she got treatment, the condition reappears in different ways, for instance, she recently had a stroke, thankfully, that was managed. When I think about it, her illness developed to this stage simply because she had no access to healthcare and financing. If she had a health cover, she would have gone to hospital much earlier and gotten treatment.

Generally, because people do not have access to healthcare, some minor health issues develop into complicated problems. Although I did not think actively about it at the time, such issues bothered me and I wanted to help resolve them. It was clear to me that I wanted to study medicine.

I started with a degree in anatomy and after the intensity of it all, completing the three years of clinical medicine left me with too much time. I therefore registered for an MBA, which I studied for in the evenings. I graduated with dual degrees (MBBS as well as my MBA).

What is keeping us from transferring best practices from developed worlds to better our own health systems?

Firstly, the realisation that healthcare is an economic driver. For you to have a productive population, drivers to economic projections, you must have a healthy workforce and also create social protection. It is that peace of mind that makes people go to work every day and be productive. Here, we view healthcare as a merely social issue, that is why we think about it as something that should be free. But it should be an industry that is heavily invested in, in terms of policy set up.

I think our healthcare infrastructure is still very wanting, especially in public facilities. I would be very happy to create a health cover that can cover access in public facilities, but if I did that, I will hardly get any clients because no one wants to go to public hospitals. But if the hospital was built and managed to the standards that it should be, then I will be able to create a health cover that is much cheaper. The rest are internal management issues that we need to deal with as a country.

Did you require any form of transition coming from clinical practice to medical business?

It was not easy especially because I started with a social (as opposed to business) mindset: what you do is for the good of the community and the profit motive is not really there, to a world where you want to have impact in the society but your deliverables are revenues and profit. It was clear for me that I wanted to combine both worlds and move into creating business that leads to sustainable development.

Looking at the general statistics, do you believe Kenyans fully understand the importance of having a medical cover?

Everybody understands, but finding the right cover that is affordable in the market is difficult - this is where the gap has been. The products are too complex. Also, if you have a cover and do not fall sick, you will begin to question whether you truly need it.

Our focus is on creating solutions that are more affordable and which can return value so that if you do not claim, there is something you still get in return. For example, in Jubilee, we are embedding wellness in the health cover, so that when you buy a health cover, you are essentially buying a healthy lifestyle.

The idea is to move away from just selling benefits when you go to hospital and that way, it becomes a lot more relevant. The gap has been creating the right covers that resonate with people. What happens to healthcare when we retire? Those are some of the solutions that we are thinking about.

What did you have to sacrifice, especially in your youth, to get to where you are today?

In my early years, I sacrificed family time. I travel a lot, but I am learning to balance that out now. When I worked with McKinsey, I travelled with my wife -- I was on the road 75 per cent of the time. When I was in med school doing the dual degree, I had to work more because I funded my MBA from the money I made teaching piano classes during my free time (a skill I learned while in high school). I still do it today. I am the choral director at the Consolata Shrine. In university I also had to sacrifice a lot of my social time.

What do you like most about having a medical degree?

Medicine trains you on structure: how to solve problems and how to arrive at solutions. And that is the essence of solving any problem – by first understanding its history. Even in business, the methodology is the same. The thing with medicine is that it is very scientific, so there is not much room to be creative, which explains why I transfer my creativity to business.

Speak to a young person who would like to follow your footsteps.

Follow your heart and take moments to reflect on what you want to achieve. Following your heart means doing those things that you are deeply convicted about.

I have grown a lot through people who have supported me. There are three levels: a mentor -- someone you can bounce off your issues and get ideas, a coach -- someone who actually guides you through how you deal with problems, and third, a sponsor, someone who will always have your back and even find opportunities for you.

But you have to be selective about who these people are. I have had to make some tough decisions, such as leaving medical practice and leaving Kenya to work in South Africa.