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"id": 1096668,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1096668/?format=api",
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"type": "speech",
"speaker_name": "Kipipiri, JP",
"speaker_title": "Hon. Amos Kimunya",
"speaker": {
"id": 174,
"legal_name": "Amos Muhinga Kimunya",
"slug": "amos-kimunya"
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"content": " Thank you, Hon. Speaker. Let me begin by thanking the Majority Party Whip, Hon. Wangwe, who moved the Bill on my behalf. I also commend the Members of this House and, indeed, Members of the Departmental Committee on Health, for the consideration of the Bill and the contributions they made. Very good ideas have been prosecuted on the Floor of this House, and I am sure it will be clear when we go through it in the Committee of the whole House in terms of some of the amendments that will be coming to actualise some of these ideas. This is a critical Bill to anchor the Universal Health Coverage, which is one of the Big Four Agenda items. As I said, the key issue on the Bill is to expand the scope of membership from what is covered in Section 18 of the current Act, which is for salaried employees, to make it mandatory for every Kenyan. As we all know, Members have raised some issues on this aspect, but when you give options to people, obviously, the people who pay are the ones who believe they are at risk. We see this happening. For instance, you find that when one has fallen sick, he or she will go and pay and then wait for three months to go to hospital. This condition, the so-called adverse selection, kills the whole intent of insurance. Making it mandatory for everyone means that those who are healthy will pay for those who are likely to be sick. Those who can afford will pay for those who cannot afford and the Government will pay for the indigents and the vulnerable. So, everyone will be catered for. I believe this is what we want, to ensure that universal health coverage is achieved. I do not want to highlight those who said what and who did not, but I specifically want to just explain something because Hon. Nyenze seemed to give the impression that Section 18 of the current Act makes it mandatory for everyone. It only makes it mandatory for those who are employed. This amendment Bill seeks to bring everyone on board. There are some issues that were raised in terms of the mandatory matching contributions by employers. If you look at the Committee’s Report and the Bill, it is not clear and we will make it clearer. The intention is that in a situation where an employer has private cover for their employees, they will not be obligated to pay the matching contribution because they have already gone beyond the situation and covered their employees separately. That aspect will become clearer when we do the fine tuning. The other issue that was raised is about having both the National Hospital Insurance Fund (NHIF) and private cover, which means that you are double insured. When you go to hospital, who pays the first bill? Currently, there has been confusion on that and some hospitals insist on having your NHIF card first before they can take the private cover. So, the Bill is making it clear that when you have a private cover, it will be the first to be charged in terms of having the first responsibility for paying a bill. For inpatients, the NHIF will pay the rebates, and if your private cover has not covered you adequately, then the NHIF will top up your private cover up to some limit that will be set up to ensure that the money does not get exhausted on only a few people. So, there is some clarity on that aspect. Members wanted to know. On the last item, the global practice is obviously to make sure that the Government pays for those who are vulnerable. This is well covered within Clause 10, where it is clear that the Government will pay for the vulnerable. It may cost the Government between Kshs5.8 billion and Kshs6 billion to pay for those who cannot pay, or the so-called ‘indigents’ and ‘vulnerable.’ So, those are already taken care of and nobody should have the feeling that the youths will not be taken care of. 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."
}