Governors want NHIF to be fair in its treatment of public and private hospitals for the Universal Health Coverage to work effectively.
Speaking in Mombasa a day before President Uhuru Kenyatta launched the UHC, governors lamented that the National Hospital Insurance Fund is quick to pay private hospitals but slow to settling public facilities’ bills.
“When you have a claim as a county to be disbursed from NHIF, it is a seriously big task yet NHIF is known to be very effective in reimbursement to private hospitals,” Mombasa Governor Hassan Joho said on Friday during the Health Sector Intergovernmental Forum on UHC at Whitesands hotel.
“There has to be goodwill. If the national government is saying let’s do this together, then pointer number one, NHIF to invest a bigger percentage into the public institutions,” Joho said.
Uasin Gishu Governor Jackson Mandago said the county has problems with NHIF overpayments made to the county.
“Even as it stands now, our facilities don’t get reimbursements from NHIF,” Mandago said.
“From my county, there are three private hospitals that receive not less than a billion shillings, while what I’m following up as a county is less than Sh200 million reimbursement from NHIF,” Mandago said.
He said NHIF must prioritise public hospitals in reimbursements.
The county chiefs said adequate health facilities and workers must be in place before the programme is rolled out across the country.
“Unless we scientifically assess the 47 counties and be able to determine a basic UHC health service provision standard, we are going to fail if we take that route,” Marsabit Governor Mohamoud Ali said.
Ali said some counties, after the launch, may suddenly discover they do not have health facilities within 50km or 60km range.
Council of Governors chairman Wycliffe Oparanya (Kakamega) raised the governors’ concerns with Health CS Mutahi Kagwe, who said the national government is ready to partner with the counties to ensure UHC succeeds.
He said counties need enough funds to run the programme.
Kitui Governor Charity Ngilu said the country is at a critical stage in realising the UHC dream.
She said 16 years ago, there was no political will to implement the programme under a different name, while the private sector was completely against it.
“We have a chance to achieve this now, not because we are richer than 16 years ago or the poverty levels have reduced, but because of goodwill,” Ngilu said.
Kitui, which has achieved relative success in the UHC programme, has seen 126,000 out of 262,000 households pay Sh1,000 each for UHC ,while the county pays a similar amount.
Machakos county boss Alfred Mutua said governors, although committed to UHC, are apprehensive with the NHIF having to take charge of the programme.
“NHIF is bedevilled with corruption,” Governor Mutua said, adding that segregating Kenyans on payment is wrong.
“Saying there are Kenyans who will pay more in private hospitals and those who will pay less in public hospitals is creating a class system,” Mutua said.
“This means the private hospitals will have the financial muscle to deliver quality healthcare services as opposed to public facilities which will be receiving less funds”.
Health CS Mutahi Kagwe, however, said the UHC will not be perfect at the onset but with commitment from both levels of government, “there will be steady improvement”.
He said there will be standardisation of payment of charges so that what is paid to private hospitals is what will be paid to public hospitals.
“This programme is not perfect, but we will strive to make it the best,” Kagwe said.
“I know we can lead the world in this particular issue. We have led the world before, like in M-Pesa. We can lead it in this. Only if we believe in ourselves”.