Scrape to the bottom of NHIF rot to give Kenyans good healthcare

By FLORENCE AKETCH OTIENO

Kenyans are left wondering how some of the country’s most established hospitals and health systems are reporting significant declines and net losses and just how billions of shillings are said to have ‘disappeared’.

How did some of the biggest brands in care delivery lose so much money, when the problem isn’t declining revenue? How did the National Hospital Insurance Fund (NHIF) get involved in the misappropriation of funds?

NHIF officials had announced plans for austerity measures in a bid to keep the public medical insurer afloat; what happened to about Sh6 billion it held in reserve for turbulent times?

According to acting CEO Nicodemus Odongo, there was a lot of misinformation on the parastatal’s financial situation, saying the Health Financing Reforms Expert Panel’s (Hefrep) report did not question its status.

BUDGETING
But a member of the senior management estimated that more than Sh5 billion may have been used on printing the Afya Care Cards for the regions where the Universal Health Coverage (UHC) project was piloted yet President Uhuru Kenyatta launched the cards in Kisumu County in December 13, 2018.

A dynamic healthcare budget process trumps traditional budgeting in terms of accuracy, flexibility and transparency with the rank of medical care swelling by the month. Pressure on hospitals to manage patients and the financial losses caused by programme reimbursement rates is mounting. If hospitals do not aggressively manage the cost of medical care, the financial future patients, in light of the fixed reimbursement rate received from the system, could be jeopardised.

As a unionised industry, hospitals continue to increase wages while pharmaceuticals raise prices at thrice the rate of healthcare inflation. Hospitals are finding it difficult to justify their investments as their leaders recklessly spend millions of shillings to expand infrastructure with the hope of attracting more business from competitors.

Many hospitals talk about becoming leaner and more efficient but few fulfil the vision. Commercial payers bear the financial brunt of hospital inefficiencies and high costs yet they lack the means to eliminate the redundancy of high-priced machines and consolidating operations to achieve superior quality and lower costs.

Investigations should focus on reports of rogue NHIF officials who might have colluded with hospitals to generate false medical bills for workers who had not sought treatment. This is because NHIF officials, in conjunction with hospital administrations, conspire to double-charge the government.

The government should also be more passionate about transforming the Kenyan healthcare system and helping the people to understand the consequences of their medical decisions. The probe should be in the tail-ends with the responsible officials arraigned and those found to be culpable punished.

The figure is fraudulent.
FLORENCE AKETCH OTIENO, Vihiga