Pooling services can lower health care cost

The main challenges facing health care providers are improving efficiency and making treatment affordable without compromising quality.

This entails lowering the cost of treatment and tackling problems that hamper access to care.

Two primary areas in health reform are lowering the cost of drugs and eradicating corruption and waste of resources.

SUBSIDIES
The high cost of drugs can be managed through increased use of generics with the same efficacy as the more expensive branded drugs.

Governments can also subsidise essential drugs such as anti-retrovirals (ARVs) to enhance access to treatment.

Transparent pricing is also vital in checking the spiralling cost of medicines.

CORRUPTION

Dealing with inefficiencies in the health care system is a more complex affair.

For instance, eradicating corruption in procurement is often a volatile process with charged political undertones.

The stakes are high and the attendant risks act as a major disincentive for reforms in the health sector.

INFRASTRUCTURE

Tackling these challenges, therefore, calls for concerted action by multiple stakeholders within and beyond the health system.

One way to minimise weaknesses in the health system is encouraging shared health/medical services and infrastructure.

A case in point is ambulance services. In any modern health system the role is primarily to offer emergency pre-hospital medical care.

TRAINING

Ambulances are also used to transfer patients from one hospital to another.

In advanced health systems, ambulances also operate as first-line treatment units.

What is initially reported as an emergency may turn out to be a manageable case.

In this case, trained medical personnel manning an ambulance treat and release the patient.

PARTNERSHIPS

This would work wonders where millions of people living in remote areas can barely access the most basic health care services.

Promoting public-private partnerships in ambulance services would help to improve efficiency.

This entails encouraging public and private health care providers and insurers to invest jointly in such services, thus freeing resources for other critical services.

More importantly, it helps lower the cost of offering such services.

NHIF
The National Hospital Insurance Fund (NHIF), the public health insurance provider, should explore partnerships with private medical insurance firms to pool services.

This not only expands coverage, but also allows optimal utilisation of assets, justifying the investment.

Some counties have invested hundreds of millions of shillings in purchasing and operating ambulances.

Such duplication results in wastage, considering that such resources are often idle.

COST

They could be put to common use and achieve better outcomes, including reduced cost of emergency services.

In essence, what we need are more ambulances serving a greater number of Kenyans than a few reserved for the exclusive use of certain health facilities.

The money saved from this could be used to train ambulance medical personnel to offer better and enhanced services.

And this is just one example of how partnerships can help to lower the cost of treatment, while improving the cost of care.

INSURANCE
Another significant benefit from pooling health care infrastructure and services is reduced medical insurance premiums.

Medical insurers would pass on the benefits of savings on the cost of providing services to the consumers.

It is high time we embraced partnerships as a reliable means of reforming our health system in the public interest.

A good starting point would be the prudent utilisation of the scarce resources to achieve better health outcomes for all.

Ms Munene is the managing director, AAR Insurance Kenya. [email protected]