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"id": 1092175,
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"type": "speech",
"speaker_name": "Seme, ODM",
"speaker_title": "Hon. (Dr.) James Nyikal",
"speaker": {
"id": 434,
"legal_name": "James Nyikal",
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"content": " Thank you, Hon. Temporary Deputy Speaker. I support the National Hospital Insurance Fund (Amendment) Bill. The purpose of this Bill is basically to mandate the NHIF and to give it structures to deliver universal health cover. Universal health cover means that all citizens can get care which they can afford. It can be done if the Government has enough money. Just put the money out there and treat people. That is all. That is what they do in Britain in the NHS System. Since we do not have enough money, we have resolved, as a country, that we are going to use social health insurance as a means of delivering universal health cover. The main parts of the amendments in the Bill are doing just that. What are the components of universal health cover if it is based on insurance? One, you have to pool funds. Money must come from somewhere. That is what we are looking at the NHIF to do. Having got the money, then you have to design. What services are people going to get? The basic benefit package that meets the health cover. Then you have to say who is going to provide this service and then you say how the payment is going to be made. In this case, if you are using the NHIF, it pools money. We decide what people are to be given, who is to give it and the NHIF pays. So, how is this Bill addressing that? First, one is actually pooling and getting as much money in the NHIF as possible. If you look at Clause 11, which seeks to insert Section 15A, it makes it mandatory that every Kenyan above 18 years of age makes a contribution to the NHIF. That is the first main thing that comes. What is happening in the NHIF is employers are just collecting money from employees and forwarding it to the NHIF. It was also proposing that employers make a matching contribution, but that has met a lot of opposition, particularly from employers. That is something the Committee is going to make amendments on, so that we do not push employers too far at this time of COVID- 19. If you say that everybody is going to pay, obviously, there are people who cannot be paying. These are the indigents. So, this Bill, in Clause 10, is providing that the national Government will pay for the indigents who will be identified by a relevant Government body. I would appeal to my colleagues that this is going to be extremely important. Some people are going to be identified because they are unable to pay and the Government is going to pay for them. The process and how that will be done is going to be extremely important. It is left to the board, but it is extremely important. In the Committee, we felt that that is an area where Members of Parliament should take part on who is identified as indigent and paid for by the Government. You see what you have done with the customs purse of old persons, orphans, vulnerable people and people with disabilities. There has been a problem of who is identifying them. So, there are some people getting there who need not get. That is also an extremely important part for the board. The law cannot go into those details. That is going to be extremely important. Now, having got the money, if everybody is going to pay and for those who cannot pay, the Government pays, we are definitely going to get a lot of money for the NHIF. If employees also start to pay, and that in my view should be done gradually, eventually employers must match what employees pay. That can be done gradually over time. Hon. Pukose was referring to voluntary contributions. People used to pay voluntarily. The problem is that they do what is called “advanced selection.” People pay when they are sick. In the concept of insurance, that is like insuring your car when it has already got an accident. That is exactly what paying when you are sick is. Actually, there has been evidence that people who are The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor."
}