alexa NHIF a social insurance concept that is misunderstood by many - Daily Nation

NHIF a social insurance concept that is misunderstood by many

Sunday July 14 2019

By ABUKAR OSMAN

The opinion piece, “NHIF discrimination is what needs debating, not MPs’ salaries”, by columnist Kaltum Guyo (DN, July 1) is a mixed bag. It contains verifiable truth, radical proposal, fallacious perception and tough calls.

The article was, apparently, inspired by an unfortunate incident to which the writer was an eyewitness. She narrates an incident in which a maid delivered at home but needed the services of a medical professional and was thus taken to hospital.

According to the writer, the mother was denied services under Linda Mama and required to pay out of her pocket on the pretext that she delivered at home, making her ineligible for the free maternity programme.

Needless to say, the facility was wrong in treating the mother the way it did! Even without free maternity, the situation was an emergency, whose treatment is guaranteed under the Constitution. Further, the programme has antenatal, postnatal and post-delivery complication component besides the delivery service package.

GOOD PROGRAMME

This is one of the few irresponsible and unprofessional partners that weigh NHIF down and negate a good programme. The writer should consider sharing the particulars of the incident with NHIF for action.

The writer made several other propositions which calls for setting the record straight. One is the Sh500 cover. The benefits package under the national scheme, SupaCover, with a monthly premium of Sh150-1,700), is a priority package with 12 distinct services.

But when the writer makes the very-little-for-you-on-a-Sh500-cover claim, that is a clear lack of knowledge of the package.

Ms Guyo belongs to the legal profession and must be aware of the requirements of Employment Act 2007 that the government and other employers seek an enhanced cover for their employees by making available more funds as premiums. Close to 80 employers have sought such an enhanced cover.

POOR FUNDING

We agree with her on a number of propositions, such as that poor funding and corruption plague the healthcare sector and there is low quality services and customer care in the public hospitals.

It is also true that NHIF premium configuration have a fallacious one-size-fits-all approach to the self-employed segment of our population. True, there are people who can’t afford the Sh500 monthly premium and those able and willing to pay more premium for an enhanced cover. We must strike a balance and satisfy the different needs.

NHIF is aware of all these realities and is willing to address them. However, the health insurance concept appears not well grounded in our people. Insurance is about pooling resource for risk management and that calls for concerted effort to ring-fence against risk.

Our situation calls for change of ways and mindsets.

Abukar Osman, NHIF senior assistant manager, Registration and Compliance, Southern Region.