Knee-jerk reactions won’t cure NHIF rot
By Editorial.Team, June 20, 2023Hardly a year passes without the National Health Insurance Fund (NHIF) landing itself in the murky waters of corruption. Since its establishment in 1966, NHIF has routinely been mired in corruption perpetuated by politicians and the ruling elite.
Numerous attempts by past successive governments to reform the insurer have come to nought as cartels in the health sector continue looting with glee. An organisation that was meant to ensure social protection and cushion families against the heavy burden of medical care, has become a citadel of graft and self-enrichment by blue–eyed boys.
Though the Health Cabinet Secretary Susan Nakhumicha has acted swiftly fast on allegations of fraudulent claims amounting to Sh1.5 billion by some private health facilities, her efforts are too little, too late. There have also been cases of some unscrupulous private facilities colluding with senior NHIF managers to inflate patients’ bills. All this continues to take place unabated as patients with genuine cases are denied medical attention either as a result of the government’s failure to remit monthly deductions to NHIF or outdated bureaucracy that has now become the norm.
Investigations into the rot at the institution have often come up with far-reaching recommendations that are never implemented.
As the few well-connected cliques continue swimming in the loot accumulated from NHIF, access to decent health care has remained a daily struggle for the sick, due to seriously underfunded national health systems, lack of basic infrastructure to provide clean water and a serious shortage of staff. According to data from the World Bank, only one in five Kenyans enjoy some form of medical cover, which means that more than 40 million citizens are excluded from quality healthcare.
Many households have been forced into incurring huge medical bills to treat their ailing members, exposing them to financial catastrophes and impoverishment. But why has NHIF failed to deliver? It is apparent that besides governance, the institution requires structural re-organisation and a proper regulatory framework. For instance, won’t be prudent to establish an independent medical review board staffed with respected professionals within the organization to determine the “medical necessity” of procedures and claims.