Doctors propose medical fee reduction

Patients and their families could be headed for better times if the government adopts proposals by medical practitioners to reduce doctors’ fees.

On Friday, the Kenya Medical Practitioners and Dentists Board presented its report to the Cabinet Secretary for Health Sicily Kariuki, recommending that the maximum and minimum fees charged by private practitioners be reduced by 20 per cent.

While both Ms Kariuki and the board’s chairman, Prof George Magoha, remained cagey about the finer details of the report, sources privy to the recommendations said it has proposed that private medical practitioners charge less for all procedures offered in private medical facilities.

CONSULTATION

The recommendation is likely to meet stiff resistance from private practitioners who have insisted that only maximum charges be reduced by 20 per cent, and not minimum charges.

On Friday, the doctors maintained that they would not implement the board’s recommendations regarding the reduction of their fees if they are adopted by the government.

If the recommendations are adopted, the minimum consultation fees charged by a general practitioner will drop from Sh1,800 to Sh1,440 while the maximum fees will reduce from Sh5,000 to Sh4,000.

Similarly, the minimum consultation fees charged by a specialist doctor will go down to Sh2,980 from Sh3,600, while the maximum fees charged by such a doctor will also reduce from Sh7 500 to Sh6,000.

The board is recommending a minimum of Sh29,800, down from Sh36,000 for normal child birth, while the maximum drops from Sh72,000 to Sh57,000.

A visit to the hospital during the day currently costs between Sh6,000 and Sh120,000. This will go down to between Sh4,800 and Sh108,000 respectively if the reduction proposal is adopted.

A visit at night currently costs between Sh12,000 and Sh18,000 but it is set to drop to between Sh9,600 and Sh14,400 under the proposed fee guidelines.

Also set to reduce, albeit marginally, are fees charged for twin deliveries which currently stand at between Sh72,000 and Sh120,000.

PROFESSIONALS

Speaking to the Saturday Nation, Ms Kariuki acknowledged receiving the preliminary report but said she had asked the Board to refine it before she releases it officially.

“They just presented the preliminary. They are working on the report further and I will release it on Monday,” she said.

Doctors had earlier warned that they would not be part of the deliberations and would not implement any recommendations arising from them.

“Why is the professional fee becoming an issue now? Whose interests are they pushing? Is the cost of healthcare about the fees?” questioned the Kenya Medical Association (KMA) president Dr Jacqueline Kitulu.

The doctors warned that reducing the fees would not be a conclusive solution to the high cost of healthcare in the country.

While admitting that the government has the mandate to set fees in public hospitals, they argued that it cannot intrude on private arrangements.

“We consider the ongoing process of reviewing the doctors’ private practice professional fees to be rushed and with inadequate input from the professionals,” said the KMA president.

EXORBITANT

“When you are reviewing the cost of healthcare in the private sector, you need to look at the total cost of providing healthcare. There are equipment, hospital and laboratory charges. We have scanned several hospital bills and the professional fees which the lawmakers are claiming are exorbitant were just 12 per cent of the whole bill,” she noted.

The doctors had earlier hinted that they were willing to enter into broad-based discussions that are not limited to private practitioners' professional fees only.

The association also challenged the government to clarify the relationship between UHC and private practice healthcare providers.

“There is a misconception that professional fees in the private sector are raising the cost of Universal Health Coverage, which is a (public) programme in public and not private facilities,” she said.

The discussion follows a directive by Parliament that the country reverts to the 2006 pricing guidelines that were abandoned two years ago with the adoption of the current rates.

In a report dated November 15, 2018, the National Assembly’s Health committee instructed Ms Kariuki to immediately replace the existing Medical Practitioners and Dentists Rules 2016 with the second edition of the Professional Fees Rules and Guidelines of 2006, which prescribes cheaper rates for various medical services and procedures.

The committee, chaired by Murang’a Woman Representative Sabina Chege, also gave the Health ministry, Kenya Medical Practitioners and Dentists Board, and the Pharmacy and Poisons Board six months to come up with a reasonable cost for various treatment regimens.

PREMIUM

However Dr Kitulu challenged the MPs to focus their attention on ensuring that the public system works, rather than diverting attention to professional fees in private facilities.

Meanwhile, insurance companies have threatened to increase their premiums if medical fees and charges are not reduced. They declared their stand during a public consultation organised by the Consumers Federation of Kenya.

A premium is the amount an individual or a business pays for an insurance policy. Once it is paid, the insurer must provide coverage for claims made against the policy.

According to the latest report by the Association of Kenya Insurers, the number of Kenyans buying medical insurance is dwindling.

The total amount in premium covers bought in 2017 was about Sh38.4 billion, compared to Sh38.8 billion in 2016, it says.

According to one official, only about three per cent of Kenyans have medical cover other than the National Hospital Insurance Fund.

“The doctors' fees in its current form will put insurance out of reach for many,” she said.

A 2017 Ministry of Health survey found that at least a million Kenyans were driven into poverty every year due to high medical expenses.