Former Health CS Mutahi Kagwe Criticises New Health Fund SHIF, Says, ‘It Won’t Work’ be
At a prior press briefing, former Health Cabinet Secretary Mutahi Kagwe expressed strong disapproval of the government’s intention to replace the National Health Insurance Fund (NHIF) with the new Social Health Insurance Fund (SHIF), asserting, “It won’t work.”
Kagwe questioned the rationale behind altering the national health insurance framework and raised concerns that insuring certain government employees through private insurers might undermine SHIF. He argued that public health funds should continue being allocated to NHIF.
“I have always struggled to grasp the need for these changes, as I believe that insurance, particularly medical insurance, is fundamentally based on probability. Therefore, funds from the exchequer meant for health should continue to be directed through NHIF,” he explained.
Kagwe specifically criticised the National Police Service’s choice to engage a group of private insurers for their healthcare needs instead of using NHIF. He contended that the Ksh8.67 billion contributed by police officers is essential for NHIF to extend coverage to more Kenyans.
“The reason I advocate for sectors like the police to remain part of NHIF is due to the accessibility of healthcare nationwide. If a policeman in a remote area like Kasipul Kabondo or Mukurweini is covered by a private insurer that has no presence there, where will he receive care?” he questioned.
Kagwe further commented, “Allocating the Ksh8 billion premium from the police force to NHIF ensures that NHIF has adequate funds to pay the hospitals serving them. But if you segregate the police to private insurers and rely on the Ksh6,000 premium we have been attempting to charge, it won’t suffice for the entire country.”
From 1 July 2024, healthcare access will shift to the new Social Health Authority (SHA) along with SHIF, replacing the NHIF system that has been in operation for over 57 years.
Under the new arrangement, each household will contribute 2.75 per cent of their income as a statutory deduction, with a lower minimum monthly contribution of Ksh300, down from the previous Ksh500 required by NHIF.
The fund will be divided into four cost categories, which the government claims will be supported by both individual and public funding.
The SHIF benefits package will encompass a broad range of services: outpatient services, end-of-life care, surgical services, specialised pharmacy benefits, inpatient and critical care, accident and emergency services, optical services, mental health services, specialised diagnostic services, renal care, overseas treatment, dental services, rehabilitative services, disease screening, assistive devices, maternity and child health services, oncology services, and medical imaging.
“Regardless of the name—whether it’s national social insurance fund, national health insurance fund—the critical factor is how well-funded it is. The larger the financial base, the better,” Kagwe stated.
His remarks have ignited a vigorous debate on the future of national health insurance in Kenya. Supporters argue that SHIF will offer more comprehensive and equitable healthcare coverage, while critics like Kagwe fear the transition might disrupt access and financial stability.
Kagwe’s views resonate with many who worry that decentralising funds and depending on private insurers could compromise healthcare availability and quality, especially in underserved areas.
The government is firm in its decision to roll out SHIF, asserting that the new system will rectify inefficiencies and broaden healthcare access for all Kenyans. However, the success of this transition will depend on its implementation and maintaining solid funding.
In Other News: Phone Prices to Increase by Ksh225 Per Unit
Former Health CS Mutahi Kagwe Criticises New Health Fund SHIF, Says, ‘It Won’t Work’