The National Health Insurance Fund (NHIF) acting CEO Nicodemus Odongo appeared before the parliamentary health committee on Wednesday, October 23 to answer to allegations on why a high number of rich Kenyans sought treatment abroad under the insurance fund at the expense of ordinary Kenyans.
The financial reports presented by NHIF before the committee chaired by Murang'a Woman Rep Sabina Chege, revealed that the NHIF paid Ksh17 billion for special packages for those who sought treatment overseas in the 2018/2019 financial year.
According to the Daily Nation, the financial reports on the funds to hospitals saw private hospitals receive Ksh22 billion while government and mission hospitals received Ksh7 billion and Ksh8 billion shillings respectively.
The committee comprising of Kesses MP Swarup Mishra, Zachary Thuku (Kinangop), David Ochieng' (Ugenya), Eseli Simiyu (Tongaren) sought to understand why NHIF paid more money to private hospitals.
The legislators issued a directive to be presented with the full list of the names of the individuals that were sponsored by the insurance fund to seek treatment overseas.
Kesses MP queried the insurance fund CEO on the criteria used to determine who qualified for treatment abroad or if it relied on the connections one had with the board members.
"You are not qualified doctors, so how do you know the condition one is suffering from, and who needs to be flown out of the country?" Mishra posed.
Eseli Simiyu stated that from the findings, it appeared that the poor were subsidising treatment for the rich but weren't getting high-quality health services.
However, in their defense, NHIF acting CEO Nicodemus Odongo reiterated that the process of selection for those who sought treatment abroad was not biased.
He pointed a finger at the Health Ministry stating, "One can not come to the NHIF and say they are going abroad for treatment. The ministry must give a green light."
Odongo revealed to the committee that the NHIF capped the maximum amount paid for those going abroad for treatment at Ksh 500,000.
He further stated that most of their members preferred private medical facilities but the NHIF did not cater for the entire medical bill. Any surplus amount was paid for by the individual.
The acting NHIF CEO stated that the fund made 100 percent payments for patients who were treated in public hospitals as a move to encourage more people to visit the facilities.
