NHIF medical cover limits likely to hurt contributors

Making healthcare affordable and accessible to all is a currency that has gained traction in the recent past and it should, therefore, come as no surprise because the agenda has been a highly appealing social objective globally.
More importantly, the health of a nation is now an economic indicator, and there is much evidence of the big contributions that universal healthcare can make in advancing the lives of people, and also in enhancing economic and social opportunities.
It is, therefore, imperative for Kenya to make adequate use of policy lessons that can be drawn from the diversity of experiences in the world. While none of these individual examples are flawless, claims by the national insurer National Hospital Insurance Fund (NHIF) that it will bar contributors from accessing certain high-cost private hospitals despite planned 430 per cent rise in total contributions, could be tragic.
Presently, salaried workers’ contributions to NHIF go up to Sh320 based on the gross monthly salary and at Sh160 for pensioners and the self-employed.
The proposed contributions which will range between Sh150 and Sh1,700 per month are expected to cover both inpatient and outpatient treatment, but contributors will not access their hospitals of choice if they include top private hospitals such as Nairobi, the Aga Khan, The Mater and Karen. Actually, the move which comes shortly after stakeholders seemed to have settled a dispute over the funds, could take the sub-sector back to the drawing board.
In the spirit of mutual reciprocity, it can be argued that while on the one hand the State health insurer is set to gobble up the mandatory contributions from employers, on the other hand the contributors will be allowed to be attended to by hospitals of choice.
The move which sets choices for the consumers by limiting them to low-end hospitals could make a majority of contributors opt for their current employer-sponsored schemes which do not limit them to certain hospitals but amount of money in their insurance cover.
As the country waits for the gazette notice on an agreement between NHIF, Federation of Kenya Employers and Cotu, the Fund must look into this issue despite claims the exclusion is a move to ensure the comprehensive medical insurance scheme goes to the mass market.
Currently, it’s cover for the disciplined forces and civil servants does not exclude the high-cost facilities making it discriminatory. Such a grand idea must be seen to meet the needs of all consumer’s because better healthcare will not only make the country healthier but also richer.