Yes, Kenyans need universal healthcare system

By Machel Waikenda
twitter@MachelWaikenda

Development agenda is a merciless and exacting taskmaster.

It is a bottomless pit of opportunity, priority-ridden, but ultimately rewarding when a country gets the mix just right. The pillars must always include food security, security, literacy and good health, and not necessarily in that order.

This month, the US government has started to implement the ObamaCare policy that seeks to ensure more Americans have access to affordable and universal healthcare. The policy has received mixed reactions but those in support say it is timely.

ObamaCare makes it compulsory for people to have health cover either provided for by their employer or by buying one of the private health plans now on offer. Those who cannot afford it will get help, but those without any insurance will be fined.

The move provides a great opportunity for Kenya to look at the implementation and benchmark what works and how some of this can be implemented locally. Firstly, the country’s healthcare policy must ensure it meets the three pillars of affordability, accessibility and quality.

Every Kenyan should have access to high quality healthcare and this is a right guaranteed by the Bill of Rights under Article 43(1a). According to the Constitution every Kenyan has a right to “the highest attainable standard of health which includes right to health care services.” The recent strike by health workers pointed to the need for a comprehensive health policy to cater for all Kenyans regardless of their status.

Our hospital services must be improved, with better pay and conditions for healthcare professionals and guarantee a higher standard of care and treatment for patients.

Health reform in the country needed to have been handled a long time ago as it was one of the stated goals of Kenya’s administration at Independence, since the Founding Fathers realised a healthy citizenry is better able to tackle the mammoth development agenda they had set for themselves. But it is never too late to tackle problems facing the sector. Every year we lose many Kenyans through preventable illnesses such as malaria, tuberculosis and HIV/Aids. We need deliberate efforts to ensure these illnesses are controlled so they don’t eat up the lean healthcare budgets.

A universal healthcare system is key as only about one in 10 Kenyans have health insurance. Our public health facilities are stifled by poor management, insufficient medical supplies and poor procurement procedures.

The healthcare policy should expand affordability, quality, and availability of private and public health insurance through consumer protection, regulations, subsidies, taxes and insurance exchanges. The national and county governments have to be stringent on spending on healthcare as only 12 per cent of current Government spending on health goes to running services. A lot of the money is lost through bureaucracy and corruption.

Government must also reform the National Health Insurance Fund to deal with corruption and red tape that has resulted in lack of accountability and entrenched inefficiency. This should include ensuring that more money from the national budget is added to peoples’ contributions to enlarge the pool.

Both national and county governments must ensure they allocate a higher percentage of their budgets to provision of healthcare services. Previous governments dedicated only six per cent of their budgets to healthcare. This must be doubled or even tripled for better health services. Government must also ensure we do not continue wasting the investments made in the training of health practitioners especially doctors and nurses who leave the country seeking better opportunities abroad.

The Jubilee government promised to first focus on preventive healthcare, as it is less expensive. The strategy should be based on networks of village-level community health workers and midwives, among others.

The Jubilee government should ensure its pledge of better access to health facilities is achieved. Their Manifesto guarantees that every family has access to a fully equipped health centre within 5 miles of their home, with a national network of local community health workers promoting preventive health services based at the centers. For a healthy national will underwrite the nation’s success or risk being a basketcase.