By Anyang’ Nyong’o
Kudos to US President Barack Obama; the US Supreme Court last Thursday ruled by a vote of five-four that the Affordable Care Act (ACA) is constitutional. This ends a long battle where vested private interests have fought his gallant attempts to bring Universal Health Coverage (UHC) to the wananchi in the USA since he came into office. The struggle has been tough; but the tough have finally triumphed. Social justice takes long to achieve but resoluteness and persistence will always bring it about. Obama has been resolute, consistent and persistent; he has made the people triumphant against the power of the rich.
On the same Thursday in the Kenyan National Assembly, as the clock was ticking close to ten o’clock in the night, Members of Parliament unanimously threw away the Report of the Parliamentary Committee on Health that was supposed to look into so-called “irregularities on the rolling-out of the Civil Servants’ Out-Patient Medical Insurance Scheme.” The Committee, in a typical neo-McCarthist style, turned into witch hunters prepared to take no prisoners provided they could hang any manner of Imagined wrong doing against the Minister, the PS, and the management of NHIF and service providers in the scheme. The result was a disastrous report full of sound and fury but signifying nothing. Parliament, in its wisdom, threw it out lock, stock and barrel as the committee chairman walked out of the House.
The NHIF so-called “Goldenberg like scandal” is definitely a scandal that never was. The media had employed a histrionic hyperbole to describe the depth of looting that was bound to cause dismay and despair among the Kenyan public. I even received hate mail and read stories about myself in the social media that made me believe I had metamorphosed into some devil incarnate. But Obama has been going through the same experience for years. What is clear is that in the typical Kenyan style, the big insurance firms and health management organisations (HMOs), which had lost the bid to implement the multi-million shillings scheme, had to hit back at the winners and scandalise the scheme. The aim was to make the scheme fail so that the Government could be forced to accept their exorbitant premiums in implementing what they called “a properly priced scheme”.
This, no doubt, is a trade war, which the losers want to win at the expense of both the Government and Kenyans. Among the losers are those who do not believe in Universal Health Coverage (they call it socialist), nor in the Civil Service Scheme as it is being implemented (they say the Sh2, 850 premium is too low and unrealistic) and others closeting in high Government positions as the owners and agents of big insurance companies. I am, and have been for a long time, their enemy because I advocate universal health coverage because this is the only way, in the Kenyan context and history, that we can implement Article 43 of the Constitution.
Let us agree for the moment that implementing the Civil Service Scheme had some problems, teething problems in fact. But when a baby gets measles or diarrhea after a year of being born, do you declare the mother incompetent or simply treat the baby and give vaccination to provide better life and survival? We have had problems with free primary education since we started it ten years ago, with allegations that billions of shillings were lost very recently. But officials at the ministry were given time to investigate the allegations and they found out that problems existed at some schools and dealt with them. In the case of the recent hullabaloo about the NHIF some people have tried to kill a fly with a sledgehammer.
he ministry, the board of management and the NHIF officers have systematically been pursuing a rational path to implement Universal Health Care. The actuarial study done by Alexander Forbes recommended the implementation of Out-Patient Care after a pilot scheme carried out in 2009/2010 with a sample that the same Alexander Forbes certified as having been scientifically representative. Yet the parliamentary health committee claims the sample used was too small and unrepresentative. There is no single actuarial scientist in the committee, let alone anybody with statistical skills to put aside the Alexander Forbes findings.
The International Finance Corporation and Delloitte Strategic Management Evaluation of the NHIF recently gave us solid recommendations and Road Map for management reforms in line with the implementation of Universal Health Care. The parliamentary committee wanted to override this with new directives to the NHIF and the ministry completely oblivious of the much more far-reaching recommendations from competent bodies like the IFC.
Very soon we shall be holding a stakeholders meeting to put before Kenyans our proposal for the implementation of Universal Health Coverage this year. This will mean accepting new NHIF rates from all contributors so that all of us can have access to quality and affordable health care that civil servants, the police and disciplined forces are having now. A few problems will still be with us to solve; but let us solve them as we implement this noble project.
I thank the Judiciary, which has consistently thrown out the reactionary resistance to this project by the leadership of Cotu. Both Cotu and the Federation of Kenya Employers, having been fully consulted during the preparation of the IFC report, are no doubt now ready to engage in a rational discussion on what is good for all Kenyans and not just a few who have other sources of health insurance.