EDITORIAL: Uniform NHIF rates right cover for health scheme

NHIF headquarters in Nairobi. FILE PHOTO | NMG 

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A bill sponsored by Soy MP Caleb Kositany aiming at standardising the National Hospital Insurance Fund fees that private hospitals charge will most likely be the right prescription for an ailment threatening the very existence of the public insurer.

Mr Kositany says standard costs will ensure that the public medical insurer is not misused by charging expensively for procedures whose rates can be standardised. The MP said NHIF-card holders have been exploited with abandon.

A number of issues arise from the state of affairs: deliberate theft by hospitals that charge exorbitant rates just because it is an insurance billing. Insurance is a contributory scheme; it is not some sort of endless resource pit that replenishes itself.

These uncontrolled charges amount to corruption, the cancerous vice that is killing the Kenyan economy. Indeed, it is baffling how the government, through its many agencies, has not smelt a rat in the NHIF billing.

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It must dawn on the hospitals, the NHIF board, the Health Ministry and the general contributors that it was only recently that premiums were raised more than four times with the goal of making the Fund sustainable. Contributors who paid Sh160 a month are now parting with premiums of Sh500. Indeed, some dropped the plan on account of affordability.

Those on more than Sh300 monthly, thanks to their gross salaries, have hit Sh1,700. While a welfare scheme means super-earners support the rest, it is unacceptable when misuse and outright theft set in.

If unchecked, the Fund that is yet to meet its expected standards will eventually die when it is starved of much needed resources by traders hungry for ill-gotten wealth. This must be checked.

For the uniform rates to be effective, the House Health Committee is proposing a regulator that will, according to Seme MP James Nyikal, scrutinise the charges. The proposed regulator should also assess the treatment procedures so that patients don’t get a raw deal.

We ask MPs, the ministry, and the NHIF team to contribute to this law amendment with rare finesse to end up with a payments plan that will not kill the scheme but also ensure the patient gets standard services.