Health
insurance uptake has over the years been very minimal, especially amongst
individuals and families. Most of the privately insured are those who get
covers through their employers or their SACCOS or social groups. For the rest
of the privately insured, the greatest challenge has been the premiums which
according to most, are very high. The others have joined the NHIF schemes. The majority of Kenyans access healthcare services using out-of-pocket payments.
The introduction of more services and benefits by NHIF has greatly changed the health insurance
industry. This is because there now are packages that with minimal
contributions one can access medical attention for both in and outpatient
services beyond the daily rebate for inpatients. This means that one can be
admitted to a government facility and some faith-based facilities and the bill
is fully paid for.
In light of
this development, it would be prudent for the private insurance sector to
provide packages that are competitively priced so as to be accessed by more
people while at the same time remaining in business. One way that this can
happen is a collaboration between them and the NHIF to introduce “top-up”
packages for individuals who would prefer specific health facilities or extra
services not covered under the NHIF packages, whether it be in or outpatient
services. This will especially be beneficial when considering the rollout of
UHC and the registration for the NHIF cover. Especially so critical will this
be if the government’s intention of having every person enrolled in an
insurance cover is enforced. More financial resources will be accrued so that
even the indigents have coverage without too much from the pockets of individuals
or the government coffers.
Private
insurance plays a critical role in ensuring there is equity and now is a great
moment for them to prove that they are concerned about the wellbeing of their
clients and not just the bottom line.
They must arise and play a more proactive and bigger role to ensure that
UHC does not stall or fail. Having been exposed more to premium calculations
and setting, fraud detection claims management, and other insurance-related
activities, they should be able to have round tables with NHIF to assist
develop packages that are not only affordable but also those that actually
provide sufficient healthcare coverage to the people so they are not left
exposed to financial hazard due to half-done service delivery.
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