Talks the only way is out of NHIF crisis
The National Health Insurance Fund (NHIF) has, in its 56 years of existence, served Kenyans a cocktail of services.
There have been stories of huge disappointments and others of great inspiration. A number of families have had their bills footed by the Fund.
There are those who were on the edge of poverty because of sickness in the family but the Fund came to their aid. In the many positive stories, Kenyans were awed that a public insurer could actually turn into a godsend.
The premiums have been minimal compared to the benefits the Fund has been offering. Programmes such as Linda Mama have been hailed not only in Kenya but globally as a game changer.
Women have been able to access much needed maternity services for a pittance. Through this service, many mothers received life saving care and children were born healthy, compared to the years when women were left to their own devices during maternity.
Dialysis patients also have positive stories to tell about the Fund as well as those who needed rehabilitation services for drug addiction. This is how the Fund is supposed to operate. It has been a lifeline for millions of Kenyans.
However, in the recent past NHIF has become a butt of jokes. When it proposed it would lower the amount of money it pays for dialysis patients were up in arms. The Fund reduced the amount from Sh9,500 to Sh6,500 per session for three sessions a week.
There had been hue and cry among government officials that the Fund was paying too much. Health Cabinet Secretary Mutahi Kagwe wondered how claims from contracted hospitals shot up from Sh19.7 billion in the financial year 2015/2016 to Sh54.6 billion in 2020/2021.
The concern, however, did not factor advances in technology in the medical field that come at a huge cost. So, the recent threat by private hospitals to stop treating patients using the NHIF card as a result of pay dispute took the country by surprise.
The situation could have been avoided if negotiations took place before the Fund announced reduction of payment made to these hospitals. There is short-term relief, however, that services will be offered until March 31.
It is our view that the government should avoid short-term extensions and address the problem once and for all. Until such a time public facilities can match private ones in medicare, NHIF should discuss with private service providers to come up with amicable ways of adjusting prices.
