President William Ruto on Friday defended new health laws, as his government seeks to raise more funds domestically to finance the Universal Health Coverage (UHC) dream.
He said the laws will transform healthcare in Kenya, save lives, empower communities and build a stronger, healthier nation.
In the new rules, the President announced that no Kenyan will be turned away from hospital and in all level 1, 2 and 3 facilities, they will get free treatment and the bill to be footed by the government via the new Public Health Fund.
The Social Health Insurance Fund will cover services at levels 4 to 6. The laws are the Social Health Insurance Act, Digital Health Act, Primary Healthcare Act and the Facility Improvement Financing Act.
The new health laws imply that every person irrespective of where they live and their social economic status has access to good quality health services, without having to go through any financial hardships.
Currently, cost of treatment depends on where patients are and whether they visit a private or public hospital.
Friday, October 20, Dr Ruto who spoke during the 60th Mashujaa Day celebrations in Kericho County said every Kenyan will be covered by a special social insurance fund card that they will present for treatment, whenever visiting health facilities.
President William Ruto affixes the public seal during the assent of the Universal Health Coverage Bills as his Deputy Rigathi Gachagua, Health CS Susan Nakhumicha (right), Attorney General Justin Muturi (2nd right), and other stakeholders watch at State House, Nairobi on October 19, 2023.
Photo credit: Wilfred Nyangaresi | Nation Media Group
Dr Ruto defended the increased tax burden for Kenyans that comes with the rollout of UHC saying that every Kenyan will pay according to their income.
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“Previously, an individual earning Sh10,000 had to part with Sh500 to NHIF, (five percent of their earnings). On the other hand, those with salaries of Sh100,000 or more contributed Sh1,700, a mere 1.7 percent of their income.
“Astonishingly, even someone with a monthly income of Sh1 million, say, the President, paid the same amount - Sh1700, which translates to a paltry 0.17 percent of their substantial earnings. This bizarre setup, he noted, meant that low-income earners were effectively subsidising high-income earners.
“The Social Health Insurance Fund signifies a shift to increased use of domestic resources for health financing and a sustainable approach, especially at a time when resources from donors and development partners are dwindling,” Dr Ruto said.
If the government implements the proposed levy of 2.7 percent on gross earnings, it means most workers will have to pay more.
Current NHIF contributions range between Sh150 for the lowest earners to Sh1,700 for the highest earners. Presently, individuals who earn less than Sh6,000 pay Sh150 for NHIF.
In the new premiums, however, those who earn less than Sh5,455 will contribute slightly less than Sh150.Individuals who earn between Sh5,455 and Sh5,999 will pay more than their current premiums while those who earn between Sh6,000 and Sh34,546 will pay less than what they are currently contributing.
However, all those who earn above Sh34,546 will pay more than their current contributions.
The President promised to ensure public resources are spent prudently and warned corrupt officials. Stressing his administration’s zero tolerance to corruption, he repeated his “mambo ni matatu” (three sanctions) caution he sent out to those who steal public funds.
“Soon you will see, that all those involved in stealing Kenyans’ money and the corrupt, their fate is sealed. I have said it before that for the corrupt, they have three things and you know what I have said about that,” Dr Ruto said.
Previous UHC financing models borrowed heavily from the National Health Insurance Fund (NHIF), locking out millions of Kenyans from the project.
The rollout failure was also attributed to Kemsa monopoly and high prices of commodities as well as poor turn-around time of orders.
On Thursday, President Ruto signed the Universal Health Care Bills, which are set to support the improvement of the UHC plan.
On emergency and chronic illness, he said every Kenyan will be treated in every hospital without any questions or need to make prior payments.
Ruto: Kenyans will be treated for emergencies, accidents without being asked questions
The enactment of the law now means there will be greater shift in healthcare from curative services at the expense of preventive and promotive services.
“This has occasioned inequity in financing, which has disadvantaged primary healthcare uptake and promotion. The Government’s mission is to build a progressive, responsive and sustainable healthcare system,” he said.
Health insurance coverage in Kenya is generally low at 26 per cent, with those at the bottom of the economic pyramid having the least coverage of less than five per cent.
According to a 2022 Kenya Health Demographic and Health survey, an estimated nine percent of Kenya’s poor don’t have health insurance.
The President explained that the high out of pocket expenditure has for a long time denied the vulnerable access to healthcare, while many have been forced to sell assets to offset hospital bils thereby impoverishing them further. It is estimated that healthcare puts 1.5 percent of Kenyan households below the poverty line.
“Recent analysis shows that, among others, the NHIF operates as a passive, rather than a strategic purchaser, is plagued by inefficiency and governance challenges, and is potentially financially unsustainable. Access to healthcare will no longer be based on the ability to pay; It will be based on the health needs of every Kenyan,” Dr Ruto said.
In the new Social Health Insurance Act, those with chronic illnesses will not dig deep to pay for medical bills while the Emergency and Chronic Disease Fund will kick in when patients exhaust their mandatory social health insurance coverage.
The Facility Improvement Financing Act will guide the counties on how to retain, manage and use revenue generated from health-related services rendered at public health facilities.
Previously, funds allocated to public health facilities are directed to the county revenue fund and are rarely re-invested into the facilities.
Dr Ruto said all Kenyans will be involved in running and managing health facilities within their localities.
“You will have the mandate to address issues of lack of drugs and report to us so that Kenyans can get access to medical care near their homes. The money allocated to each facility will not be re-allocated. Church leaders, development partners, civil society and residents will be part of the management so that we deal with corruption,’’ he said.
Additionally, 100,000 community health promoters expected to transform healthcare at the grassroots, will receive a stipend, in a programme whose funding will be a shared responsibility by the national and 47 county governments. He pledged Sh3 billion in funding to support 100,000 community health promoters across the country.
The Facility Improvement Financing Act addresses underfunding in public health facilities, while the Digital Health Act streamlines technology adoption to enhance data sharing and resource utilisation.
