Four reasons why Kenya’s universal healthcare will fail
By Dominic Ruriga | December 28th 2017
There was an article published in the Standard by health Cabinet Secretary Dr Cleopa Mailu titled: Securing Kenya’s future with health insurance for all. While I agree with Mailu on the need for universal healthcare for every Kenyan, I think the plan is not well thought out and will cause more harm than good in the long term.
These are my reasons below:
1.Medical insurance should not be the focus when it comes to universal healthcare.
The focus should be on making healthcare affordable. Countrywide medical insurance, if not carefully pursued can lead to a significant increase in demand for healthcare services.
Insurance companies in Kenya are currently grappling with the bad habit of Kenyans of seeking medical services, not because they need it but because they paid for the insurance covers.
Basic economics teaches us that an increase in demand assuming supply is constant is going to push the price up.
The question to ask is if the cost of medical services is pushed up by medical insurance, what happens to the part of the population that will not access this insurance?
It is wishful thinking to believe that the government can enroll all Kenyans into the National Hospital Insurance Fund (NHIF) scheme.
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There is always a part of the population that will be left out, and this part most of the time are the people who cannot afford medical care in the first place.
2.Unsustainable NHIF model
When we push demand for healthcare up, then the NHIF scheme in the medium to long term will have funding pressures and two things will have to happen;
Either the members increase their contributions, (like what happened in 2015) or tax payers chip in to cover the deficit (meaning more taxes for Kenyans).
Either option not good for the country considering the resistance by unions on increasing contributions and the pains of overburdening an already overloaded Tax payer.
3.We need more clinical officers not doctors!
I agree with the need to increase the medical infrastructure across the country, but again your strategy here is punitive to the tax payer and less accessible to a majority of healthcare service users.
Increasing referral hospitals to 93 across the country, employing 2,500 more doctors and 52,000 more nurses, means you have misdiagnosed Kenyans healthcare challenges.
What we need is increase in level two, and level three facilities that will penetrate the most rural corners of the country. What we need are more clinical officers working in the rural health facilities.
We talk of Malaria, Typhoid, Cholera, HIV/AIDs as the most prominent diseases in this country. Do we need 93 referral hospitals to cure these? Do we need 2,500 doctors to treat these conditions?
4.Strategy has no mention of preventive measures
This should be by far the most important part of the health care strategy because of the cost effectiveness it brings.
In Ganze, Kilifi County, people in these villages do not have basic utilities like toilets and clean water. They also do not have access to a healthcare facility. Kenyans living in such areas are dying every day because they don’t know the importance of washing hands or using toilets etc. This can be remedied by executing a clear strategy of capacity building in the populace.
The recent outbreak of cholera again could have been prevented if the health ministry took a keen interest in educating the population about the dangers of poor sanitation. Other Lifestyle diseases that are affecting this country can be prevented by a clear long term strategy of educating Kenyans on the need for a proper diet and exercise.
Keeping Kenya healthy should not just be about buying dialysis machines and training thousands of doctors.
Bring on board community workers and nutritionists and private sector players, then craft a well thought out campaign to teach Kenyans how they can stay healthy, then we will spend a fraction of what had been envisioned to be spent by 2022.
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