Kenyan workers will not be allowed to contribute less than the stipulated rates to the National Hospital Insurance Fund (NHIF) as the government moves to mobilise funds to roll out a universal health insurance scheme to cover the poor.
The government-owned insurance cover provider has increased the monthly contributions for its members from Ksh320 ($3.33) — payable monthly for workers in the formal sector — on a graduated scale that will see those earning more than Ksh100,000 ($1,041.66) pay Ksh1,700 ($17.7) per month.
The lowest paid worker, under the new rates, which became effective on April 1, pays Ksh150 ($1.56); self-employed people remit Ksh500 ($5.2) to the statutory health insurer.
Simeon ole Kirgotty, the Fund’s chief executive, said employed Kenyans have the responsibility to take care of the poor.
“NHIF is a social cover. You are obliged to help society. It works on the principles of the young supporting the old, the healthy supporting the sick and if you are working you have to help the others,” Mr Kirgotty told The EastAfrican, adding that, “This is a step towards a universal health cover. We are on the road towards achieving that goal.”
According to Mr Kirgotty, the statutory contributions to the Fund will be extended to the informal sector to boost resources for running the universal National Social Health Insurance plan.
Workers hoped that they would only contribute the minimum to NHIF, and be allowed to continue with the private schemes so that a large proportion of their salary would not be taken upon by health insurance.
Under the new plan, the government says it will take care of the elderly, and those who are extremely poor in the society will be funded by the World Bank under the Health Insurance Subsidy Programme (HISP) which became operational on May 1.
The World Bank has already released Ksh190 million ($1.97 million) for the programme.
“This is how we are moving towards the universal health insurance cover,” said Mr Kirgotty.
Previous attempts to implement the universal National Social Health Insurance Scheme had met intense resistance from various stakeholders, including the Central Organisation of Trade Unions (Cotu) and Federation of Kenyan Employers (FKE) over who would bear the burden of its funding.
The organisations argued that the state should not abandon its duty of providing healthcare to its citizens by passing the burden to ordinary citizens.
The latest development means that workers in formal employment, who are also members of private health insurance covers, will continue making payments both to NHIF as well as their respective schemes.
According to the Consumers Federation of Kenya (Cofek), the gazette notice for the operationalisation of the enhanced rates was rushed through without adequate consultation, putting taxpayers’ funds at risk.
“There is confusion as to whether these rates should be based on gross salary or net salary, and, as currently constituted and structured, NHIF cannot offer value for money,” said Stephen Mutoro, the secretary general of Cofek.
“We see this actually as fraud on the people of Kenya. But, going forward, I know Kenyans will be willing to pay even double the rates they are proposing if they are guaranteed value for their money,” Mr Mutoro said.
According to Mr Kirgotty, the funds raised through the increased contributions will be channelled to the selected hospitals by June, and Kenyans will start accessing the services by July 1.
“At NHIF, we don’t have limits on accessing the services because we are relying on public and mission hospitals,” he said.
In the current financial year, the government has set aside Ksh500 million ($5.2 million) to pay for the insurance cover for persons under the social safety net programme.
The amount is part of Ksh14.38 billion ($149.79 million) that the government put aside to enhance its national social safety net programme in form of cash transfers to combat poverty and promote equity in the society.
The programme, which was approved by the World Bank in 2013, seeks to cushion the poorest and most vulnerable households from effects of crises such as drought, malnutrition, and unemployment.
The government allocated Ksh7.2 billion ($75 million) for orphans and vulnerable children and Ksh4.9 billion for the elder persons.
In the 2013/2014 financial year, Treasury Cabinet Secretary Henry Rotich allocated Ksh13.4 billion ($139.58 million) towards cushioning the less fortunate, poor, elderly, and persons with disabilities.
Last week, the Kenya National Union of Teachers (Knut) warned of a possible strike if the new rates were not suspended.
Knut secretary general Wilson Sossion said the April deductions from workers’ pay should be refunded to all contributors, failure to which all teachers will resort to a massive strike beginning June.
Mr Sossion said teachers were not adequately consulted before the new rates were enforced.