The idea of having comprehensive medical cover for teachers wasn’t a bad one. Before, teachers had been exposed to embarrassing situations every time they fell sick.
So the coming of AON-Minet in July 2015 was a reprieve for many teachers who were in dire need of medical attention. The scheme with some good products that cushioned teachers.
The intention was actually to address direct aspects of illness that drained teachers’ resources. Aspects such as outpatient cover, inpatient cover, dental, optical, maternity, group life, life expense, air evacuation, international referral and international travel with respective expenditure limits were God-sent and helped a good number of teachers.
We have in the past seven years heard testimonies and seen what the cover has done to some of our colleagues. We witnessed our colleagues being flown out of the country for specialised care under the AON-Minet's arrangement. That would not have been possible without insurance cover.
The deal was, however, sour for teachers who could not access service providers in their areas. While some areas have good medical infrastructure such as hospitals others do not and teachers have to travel long distances to access services.
The procedure of securing authorisation required a specific network, which was not available in many areas making patients to wait for approval for many hours.
There also existed cases of some providers lacking essential medicine for patients under this cover. And finally, there were delays in clearing claims from hospitals and other medical providers which led to most of the institutions denying teachers services.
The initial arrangement was to have service providers paid quarterly so that they also would be able to pay their bills. As a result of delays, many service providers started frustrating teachers and sending them back when they sort treatment.
The fact that teachers noted several issues in service delivery by medical service providers and raised these with Kenya National Union of Teachers led to the formation of County Governance Councils (CGC) across the 47 counties in September 2017.
The CGCs were to sit quarterly to address the concerns of teachers. Our Knut county elected leaders sat in every county to represent teachers. This still happens to date. To some extent; services started improving. We received positive feedback over this initiative in most of the areas the councils interacted with our members nationally.
But teachers still complain to date over the manner in which they are handled when they visit some accredited service providers. We have noted as their representatives that the complaints they are raising are the same as those they raised previously.
Delays in authorising prescriptions, the seven days capitation for outpatient cases, issuance of generic drugs to teachers and the opaqueness in how billing is done are among the complaints.
The government appointed Medical Administrators Kenya Limited to bridge health care gaps and see to it that standards are put in place to assure quality in serving teachers through their medical insurance covers. Commendable improvement has been seen in the services rendered as a result.
The AON-Minet's contract came to an end on October 31, 2022. Tendering was to be determined by the budget ceiling of Sh15 billion by the National Treasury. We are reliably informed that several insurance firms have expressed their interest to cover teachers. For instance, NHIF which was requested by the employer quoted Sh23.9 billion which is far higher than the provided budget.
Many of us, including our teachers, thought that a comprehensive NHIF cover would be better. On the contrary, the NHIF is reportedly asking for Sh8.9 billion above the budget. We are optimistic that Treasury will appropriate more funds so that teachers can access the best.
Whereas it is not Knut's mandate to contract medical insurers for teachers, it is our duty as teachers’ representatives, to push for what is best for them. We have raised concerns in the past about medical providers who have underperformed.
Such providers have either been advised to up their game or have been dropped due to non-compliance. Our position still remains that teachers deserve the best.
All said and done, it is notable that Kenya has not invested adequately in good medical infrastructure. Private investors have made good efforts, but they are not enough.
We need better public medical facilities across the country so that teachers and other citizens can receive satisfactory medical attention. The provision of quality medical care is a fundamental human right and the Kenyan teacher should assured of the same.