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{
    "id": 1092176,
    "url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1092176/?format=api",
    "text_counter": 221,
    "type": "speech",
    "speaker_name": "Seme, ODM",
    "speaker_title": "Hon. (Dr.) James Nyikal",
    "speaker": {
        "id": 434,
        "legal_name": "James Nyikal",
        "slug": "james-nyikal"
    },
    "content": "making voluntary payments are taking a lot more money out of the NHIF than they are putting in. The Bill is removing voluntary payments and taking care of indigents. I think it is a good way to go. When we get this big pool of money in the NHIF, there will be a big problem of management. There have been efforts to reform the NHIF. If there is a lot of meat, there will be a lot of flies. So, we have to really work as the management and look at ways of stopping graft and fraud. Efforts have been made to do that. Now we have the money and we are managing it well, but then we have to decide what our people are going to get. What services? The benefit package. What is happening in the NHIF is that we have very many benefit packages. Some are financed differently. We can do MRIs and surgery in some cases. We can do dialysis is some conditions. There is even money we are pooling from civil servants. All that is making the whole thing complex. We can even take people abroad. It is making the whole thing very complex to be manage and, therefore, it will be important that we get a proper benefit package that is clear and easy to manage. Efforts are there to work on that. If you have decided that this is what our people need, for which the NHIF is going to pay with the money that you have pooled, then we have to decide who is going to provide the service. In this country, basically, you have private health service providers and Government health services. This is where the problem is. If Government services were run well as before and the NHIF was paying for them, it would be easier because Government facilities even at the county level are funded from the Exchequer before they even get money from the NHIF. So, we should get better services there. It is possible because it has been done before. It is only from 1982 that services in the Government started to go down. In 1979, maternity services at Kenyatta National Hospital, which is now where the Kenya Medical Training College (KMTC) Headquarters is was definitely better than the Nairobi Hospital maternity services. I know it can be done. So, we must work to make Government services work. Most of our people go to mission hospitals and the small and medium-sized private hospitals. The big hospitals are only about 12. If we did not have them, the health indices would not change, but you would have a lot of political problems because the guys who go there are very powerful. We should target those that most of our people go to, so that they can provide services."
}