Nakhumicha, here is Kenyans’ problem with SHIF

Greetings Madam Susan Nakhumicha.

I hope you are keeping healthy as you steer the sickly and sickening Ministry of Health. Kindly accept this epistle, which I have postponed many times, as my contribution to the Social Health Insurance Fund (SHIF) validation process. In the health sector lingo, I would brand it ‘truth serum’.

Madam, your mien, stamina and sense of conviction in public is admirable.

You sound convincing and well-meaning every time you address the nation on healthcare matters except on the transition from NHIF to SHIF, especially on the attempt to assure Kenyans that they will be suffering for their own good when the increased national health insurance scheme rates kick off.

Your doublespeak and back-and-forth on the scheme baffles. Your about-turn last week on the contribution commencement date underlines the confusion.

On February 27, you assured that contributions would start in July but last Thursday, barely a fortnight later, you shifted the goalpost and now it starts this month but beneficiaries will have to wait until July to enjoy the benefits. What’s the pressure to collect this levy? You seem to be acting under duress, Madam minister!

With due respect, this reminds me of a character in the Animal Farm—the Squealer, Napoleon’s spokesman. That excellent communicator and master of PR, Squealer had it easy manipulating animals’ perspectives on unpalatable policies.

For starters, Napoleon was the tyrant who ruled the farm after the revolution that evicted Mr Jones from his Manor Farm, before it was renamed the Animal Farm.

In the novel, it is Squealer’s headache to explain every shift of a goalpost. For instance, he persuades animals to grant preferential treatment to the pigs against the agreed rule that all animals be treated equally. He says it’s for the benefit of all other animals.

Madam, your actions and tone seem to shout that SHIF is the ruthless saviour Kenyans must never resist! Time will vindicate you.

NHIF failed, according to you, because of its curative approach and widespread fraud. You now assure SHIF will avoid the traps because “it will prevent Kenyans from being sick…and has foolproof security against graft.” Noble! Who in right senses would mind that?

That’s the government’s problem with NHIF. But why are most Kenyans opposed to the change? While it’s largely acknowledged that NHIF doesn’t inspire public confidence—what with the rate of fraud and poor services that define it—these are not insurmountable challenges. NHIF’s issues can be resolved with little or no extra cost to the taxpayer, if someone invoked the law with the right intentions.

Madam, it seems a problem with you and your bosses that some Kenyans earn a lot and contribute little to NHIF hence the effort to rationalise this under SHIF. But isn’t access to quality basic healthcare a responsibility of a government to citizens, which should be free? It’s unfair to punish citizens just because they have a “fat” payslip.

Before I’m accused of trashing a noble idea, Madam, take my prophecy—whatever bedevilled NHIF will soon be baying for SHIF’s blood. You just renamed the forest. The monkeys and the trees remain the same and are guaranteed of a very ample environment to perpetuate their dirty business.

You’ve told us SHIF will end the era of WhatsApp medical harambees. Good news! But how? Pray you won’t be invited to one, months after SHIF rollout. NHIF lived with such dream all its time. Persuade us SHIF won’t prescribe the same dose as NHIF.

Minister, SHIF is bad news to couples. The scheme seems to burden and limit families. SHIF contribution should be per household. So will salaried couples qualify for reliefs on proving their marriage?

Finally, what’s the rationale of existing NHIF scheme members, whose biodata is in the safe custody of the same office implementing SHIF, to reregister? Why not transfer the details? Kenyans are over-registering—registrar of persons, Immigration, Huduma, NHIF, KRA, NSSF and now SHIF.

This is an unnecessary burden, Madam CS.

—The writer is an editor with People Daily
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