NHIF, Cotu want open, statutory contributors separated
NHIF acting CEO Nicodemus Odongo (centre) when he appeared before a House committee on October 23, 2019. PHOTO | FILE | NATION MEDIA GROUP
What you need to know:
- Mr Atwoli noted that the member management review will provide an affordable and accessible health coverage for every Kenyan worker.
- Out of Sh58.1 billion member contributions collected every month, Sh53.4 billion was used to settle benefits payout as at June 2019.
National Hospital Insurance Fund (NHIF) voluntary contributors could be locked out of the scheme and instead be covered under the universal healthcare if a proposal tabled at the weekend is implemented.
The proposal by NHIF and Central Organisation of Trade Unions (Cotu) could affect over a million members, mostly drawn from the jua kali sector and retirees, who pay Sh500 monthly.
In a joint resolution between Cotu and the health insurer, the two called on the government to immediately implement the programme to enable NHIF achieve its mandate.
In a statement read by Cotu Secretary-General Francis Atwoli following joint deliberations in Kisumu, the workers’ union and the health insurer pointed out that the separation of voluntary contributors’ accounts from the statutory contributors account will ensure provision of quality services to the target group.
VOLUNTARY CONTRIBUTORS
“NHIF and Cotu noted that maintaining voluntary contributors is costing the fund excess of Sh10 billion in benefits payout. We demand for immediate separation of members in the two categories,” Mr Atwoli said at Tom Mboya Labour College in Kisumu yesterday following the deliberations. Voluntary contributors pay Sh6bn in contributions but consume Sh15bn.
Mr Atwoli noted that the member management review will provide an affordable and accessible health coverage for every Kenyan worker.
“Cotu calls upon the government to immediately take up and fund the health insurance for non-statutory contributors through the Universal Health Coverage (UHC),” said workers’ union boss.
NHIF acting chief executive Nicodemus Odongo noted that the expansion of benefits over time and increased awareness about NHIF and medical inflation have led to benefit payout ratios that need to be controlled to be commensurate to premiums received.
Out of Sh58.1 billion member contributions collected every month, Sh53.4 billion was used to settle benefits payout as at June 2019.
“This scenario has become a matter of concern and we have resolved to ensure the fund remains sustainable into the foreseeable future,” said the joint communique also signed by Mr Odongo.
According to NHIF records, principal membership has grown from 5.48 million as at June 2015 to 8.46 million as at June 2019.
REIMBURSE HOSPITALS
Consequently, member contributions have increased from Sh17.2 billion as at June 2015 to Sh58.1 billion as at June 2019.
Going forward, NHIF will also cease to reimburse hospitals for all health services offered to members before co-insurers.
As a way of standardising pricing for services, procedures and medical products, NHIF will adopt a scientific evaluation of existing and new benefits to ensure it pays same amounts to healthcare service providers to promote equity, sustainability and access.
They, on the other hand, rejected the proposal to have Insurance Regulatory Authority (IRA) define the schemes given to public organisations as it happens with commercial insurances.
“These managed schemes are not for profit, therefore cannot be treated as commercial but rather government to government partnership,” said their statement.
In their nine-point agenda, they agreed to have periodic consultation on issues such as new beneficiaries waiting period, upfront payment to access benefits and a number of allowable dependents per card.
