One of the suggestions managers of faith-based health facilities planned to float at a Monday morning press conference before State House hijacked it was for the country to revert to NHIF as the government sorts out issues bedevilling the new Social Health Insurance Fund (SHIF), especially the IT system.
They argued that it was impossible for their hospitals to see patients if they are not registered and the claim system is not working properly. As it stands, the hospitals, which treat 40 percent of Kenya’s patients, are owed Sh7 billion in unpaid medical bills accumulated under NHIF. They are worried that may not be cleared any time soon.
The CEOs of the hospitals had many questions, but the top one – and indeed one that’s on the lips of many Kenyans – is: What was the hurry to switch from NHIF to SHIF? They cited gaps and wondered whether there is something that only the government knows.
The new healthcare scheme introduces the Primary Health Fund for basic care at community health facilities; the Social Health Insurance Fund for advanced services at middle-level hospitals; and the Emergency, Chronic and Critical Illness Fund to respond to emergency and long-term treatments.
But as days pass, the promises of the scheme are becoming a mirage, as witnessed at health facilities across the medical-care spectrum. Patients are being turned away from health facilities. Kenyans trying to register on the Social Health Authority portal are encountering technical hurdles. And hospitals, as of this week were still claiming Sh30 billion from the government.
Medical Services Principal Secretary Harry Kimtai argued that implementing health reforms under a new system is not a walk in park. So the question remains: Why the rush?
The government could have shielded itself from blame by being honest up front and explaining to Kenyans that in every scheme that involves a lot of money, there would always be unpredictable forces involved.
The key element here is powerful political interests and stakeholder influence, economic margins, and to some extent the perceptions of Kenyans about the new scheme.
And while this makes implementation outcomes difficult to predict and control, it also exposes the government’s dishonesty and lack of clarity.
To succeed, however, the government must focus on transparent communication, strategic partnerships and efficient reimbursement to build a sustainable health system. It would do well to learn from success stories across the world on universal health coverage.
