By Anyang' Ny'ong'o
In 1989, the National Hospital Insurance Fund (NHIF) fixed rates paid by contributors at Sh30 per month for the lowest contributor and Sh320 for the highest contributor.
In other words the gardener who works for me pays Sh30 and I pay Sh320 every month. When any of us falls sick and is admitted to hospital, the NHIF will cover part of our bill and not all.
Our contributions are too low to make it possible for the NHIF to cover the bulk of our in-patient medical care in present day Kenya.
Over the last 20 years, NHIF board members, where Central Organisation of Trade Unions (Cotu) is aptly represented, have been touring many countries to look into how social health insurance is run.
From these trips, numerous reports have been written and discussed every year and lots of recommendations made.
Going through all the reports and recommendations, there are two constant issues: one, that the current rates of contributions are too low, they need to be revised to keep up with inflation, purchasing power parity and the real cost of health care; two, that the NHIF should implement a Universal Health Coverage Scheme (UHC).
In 2008 we decided to finally implement these recommendations and put a stop to trips, studies and reports.
We, therefore, hired the International Finance Corporation (IFC) to undertake a Strategic Management Review to find out why and how the rates should be revised and UHC implemented.
We also sought to know what management and structural reforms were necessary to ensure that NHIF delivers on its mandate competently, cost effectively and efficiently.
The report is robust and provides a clear roadmap for the NHIF to deliver on its mandate.
IFC consulted all stakeholders, including Cotu. When the report was out we discussed it at a stakeholders workshop at the Panafric Hotel where Cotu was represented.
The workshop resolved that the move towards universal health coverage was laudable and should be implemented.
It was observed that the pilot study that had been carried out on outpatient coverage needed to be fully cascaded as universal health coverage is implemented.
It was, therefore, appropriate that NHIF seeks to overcome all hurdles in implementing the Civil Service and Disciplined Forces insurance scheme as this was well within its (NHIF) mandate and was a good precursor for UHC.
Indeed both court cases that Cotu filed and lost against the new rates have emphasised the need for the NHIF to deliver on its mandate in public interest.
The IFC has crowned this by very clear recommendations worthy the attention of all stakeholders.
The NHIF was the vision of the founding fathers of this nation. It was launched in 1966. Other nations in the East African region eventually followed in the footsteps of Kenya, with Rwanda being the latest in 1998.