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{
    "id": 300714,
    "url": "https://info.mzalendo.com/api/v0.1/hansard/entries/300714/?format=api",
    "text_counter": 849,
    "type": "other",
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    "content": "allowance, I found that we could get our employees medical insurance charged by the Government doubling those allowances. I was able to put a paper to the Cabinet and I got approval. Initially, the Ministry of Medical Services and the NHIF, when the Cabinet approval came in, the chairman of the board of the NHIF complained that I was taking business which they should have given to the private sector and that they should be allowed to tender for this business. I said: “You can tender for the business but I am placing it to the market as a whole and not restricting it.” In fact, the first tender was in June when the NHIF tendered through a broker, Eagle Insurance Brokers, but the broker came in ten minutes late and that is why their tender was not evaluated. When we evaluated the tender, the most responsive tender was asking for Kshs12 billion. I told them: “How do you charge me Kshs12 billion but I have figures of what you are charging in the market and they are not more than Kshs5 billion”? So, I cancelled the tender and retendered again. By the time we were retendering again, NHIF applied now with a consortium that was responsive and who had agreed to reduce the premiums from Kshs12 billion to Kshs4.3 billion. The problem arose that the exclusions which they had made on the scheme were not good enough for me. I called the chief executives of all the companies and I told them that I am also a medical underwriter and that I design these products and some of them have worked. Why would you want a scheme like the Public Service Health Insurance Scheme to have a stop-loss clause which would say that if the losses exceed 70 per cent, they cancel the insurance? I told the chief executives that, for purposes of our public servants, I would rather they substituted the stop-loss clause with a premium review clause, so that if my employees are too sick and the claims are higher than 70 per cent, we review the next year’s premiums based on actual claims. They told me that, that was a good idea but they could not do it because they had existing re-insurance treaties, whose other parties would not accept that arrangement. I asked: “How are you going to do it?” Madam Temporary Deputy Speaker, that was when I discovered that this risk had been assessed to be 52 per cent outpatient, 30 per cent in-patient, 15 per cent life insurance and 3 per cent last expense; and that they intended to pass the 52 per cent outpatient component to the National Hospital Insurance Fund (NHIF). So, I said: “If you cannot reduce the exclusions, including the HIV/AIDS exclusion, and you want outpatient, which is the riskiest component, to be given to the Government parastatal, the procurement law allows me to negotiate directly with the Government parastatal without re-tendering.” So, we invited the NHIF to give us a technical proposal, which they gave and offered to cover families comprising of employee, the spouse and five children."
}