Medical Services Principal Secretary (PS) Harry Kimtai on Wednesday sent a message to all Kenyans who feel they are not getting the level of treatment they deserve despite hefty Social Health Insurance Fund (SHIF) contributions.
Speaking during an interview with KTN News on October 30, Kimtai reiterated that the fund was aimed to provide equality and a standard treatment scheme for all Kenyans based on their gross income.
Even though this means that most Kenyans would need to pay more than others unlike in the National Health Insurance Fund (NHIF) where the disparity was not as large, the PS noted that the level of treatment would remain the same across the board.
As a result, those who feel aggrieved were advised to consider getting an additional private insurance.
“You do not say that if you are paying more in terms of your income, you should not get more benefits. It’s standard. If you like extra, you can pay for another cover like a private cover,” Kimtai said.
He further noted that the social aspect of SHIF meant that every Kenyan, no matter their background, would have to contribute equitably based on their salaries. He noted that the older NHIF cover often disadvantaged low-income earners and highly favoured upper-class earners.
“We came with a standard and a uniform figure which is 2.75% for the purposes of equity. Previously, there were those who paid Ksh500 and their earnings were Ksh5,000 which means they were paying 10% of their income. Then there were those paying a maximum of Ksh1,700 and their salaries were Ksh100,000,” Kimtai pointed out.
“We realised that we needed to bring equity for everybody based on income and we did the average. We came to 2.75% that if everybody pays 2.75% of their gross income then it brings in income.”
Further defending the government’s decision to roll out the new model, he noted that they needed to draw the country away from the need for Harambees to fundraise for hospital bills as had been the norm during the previous payment scheme that often led to a pile-up in hospital bills.
“The reason why we did this was that, as a nation, we still had the Harambee spirit where when our brothers, our sisters as a family are not able to meet the medical expenses that we have incurred, we even go outside the family. But if we all contribute as a nation, then we will be able to cater for the treatment for all Kenyans.”
PS Kimtai also noted that an insurance premium financing model under SHA was being developed and would eventually provide an upfront payment option for users who needed better treatment options.
In the meantime, all Kenyans will need to settle for the monthly 2.75% contribution and accept the same standard of care even though some are paying more than others.
He also announced that the biggest SHA challenge which was hospitals turning away patients despite having registered to the model and kept up with their payments would soon be solved as the government had disbursed Ksh9 billion to clear all NHIF debts owed to health facilities.
