The offices of the now defunct National Hospital Insurance Fund in Nairobi.
If it ain’t broke, why fix it? That is a question to ask of NHIF. Clearly it is loved by Kenyans, especially those who attend public healthcare facilities. It is not perfect, but it appears to have served Kenyans with a degree of satisfaction.
I am one of those Kenyans whose mothers relied on and benefitted from it. The peace of mind that came from knowing that NHIF is there for you and your family – no money can buy. I speak again from the converted. As long as you paid your subscription, you knew you were in safe hands with the NHIF. What was the rush and the murky reason to change something that has been useful and helpful to Kenyans?
The government has been tripping on its tongue to try and explain SHIF/SHA to Kenyans and they are not buying it. NHIF was a language that Kenyans understood, and it became part of the strong fabric of our society. It rolled off the tongue easily and even the most illiterate of Kenyans knew it had its back.
NHIF, like NSSF, is a legendary national institution that naturally instilled the sense of nationhood. They have not been free of corruption, and that is not the fault of Kenyans, but of those appointed to protect it from corruption who allowed them to be abused.
With corruption getting worse than it ever has been, Kenyans get triggered by any new changes that the government tries to bring about without proper consultations. Public participation is only on paper and a box-ticking exercise, only taking place after the horse has bolted and the gate shut.
If truly proper public participation was conducted prior to the rollout of SHIF/SHA, the government would have realised that Kenyans prefer NHIF and won’t have voted for its defunct. Relying on a compromised Parliament, only made the exercise of establishing SHIF/SHA even more dubious. The government was challenged on SHIF/SHA because it failed to talk with Kenyans but talked at or down at them. That has rubbed many the wrong way.
Pride and dignity
Once you talk down to people, they feel that their pride and dignity is at risk. The modus operandi of the government has been about talking down to Kenyans than with them and this has caused a lot of resistance.
Going on the defensive does not take away the tension between the government and the public. This is what now needs to change. Hence, let us have an honest conversation on NHIF rather than forcing an untested model of healthcare funding on them. There is no embarrassment in going with what the people want. The government is meant to serve the people after all.
The disbandment of NHIF has left many patients suffering. I get emails from Kenyans wanting help to pay for their care in a way I haven’t seen before. Kenyans should never have to beg at their hour of need, especially for healthcare. It is the government’s responsibility to ensure that there is a healthcare system that will not leave Kenyans as vulnerable as they are now.
The end of NHIF has not only been detrimental to patients but to private hospitals, too, that claim to be owed billions of shillings by the NHIF. Ending the NHIF without making sure it has met its commitment to healthcare providers was irresponsible and fraudulent. The question to ask then is: What happened to the billions that should have gone to the hospitals from NHIF? Ignoring all the allegations of corruption that affected the NHIF and setting up a new system has derailed the operations of the hospitals and left patients suffering.
Healthcare system
It is important to rethink what benefit a hurriedly set up healthcare system is to patients, when it has failed at the first hurdle and is facing resistance from Kenyans. SHIF/SHA have no credibility given the fact that it is linked to Adani holdings and now his ghosts even after his indictment in the USA for corruption.
Besides corruption, the other issue that beguiles Kenya’s healthcare system is the issue of class. Those in government that decide the healthcare system for 50 million plus Kenyans have private healthcare cover funded by the public. They lack the knowledge and the experience of using public hospitals. They cannot claim to understand the public healthcare system if they do not use them. They are the wrong healthcare advisors.
If the government is indeed serious about building a fair and effective public healthcare system, it must first stop private healthcare cover for public servants. Secondly, it should revert to NHIF where the system has served Kenyans reasonably better and has more credibility than the new SHIF/SHA system.
Thirdly, it should ensure that all public servants regardless of status sign up to the NHIF. If they want cover for private healthcare, they should pay from their pockets. It is unfair for poor Kenyans to dip into their pockets to fund their care, when public servants have better care in private hospitals. Let NHIF just be and save lives!
The writer is a legal researcher; [email protected]; @kdiguyo
