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{
    "id": 300719,
    "url": "https://info.mzalendo.com/api/v0.1/hansard/entries/300719/?format=api",
    "text_counter": 854,
    "type": "other",
    "speaker_name": "",
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    "speaker": null,
    "content": "up to January was formal signing of the evidence document called the “contract”. The Committee talks of rushed and rushed implementation of the scheme. The NHIF wanted the business from the beginning. They were part of the tendering process and all the explanations from June. When I asked them: “Can you commence from 1st January?”, they said “yes”. Madam Temporary Deputy Speaker, why did I ask the NHIF whether they would commence from 1st January? It is because I had been given Kshs1,078,000,000 more, away from the allowances. So, I could not keep that money a day more when employees were dying in Somalia, and others going to the Government for medical expenses reimbursements. Each of these employees was already a member of the NHIF. Their particulars were in the database of the NHIF. One of the ways services can be rendered by the NHIF is by service for fee, which is what they are doing for in-patient, life insurance and last expense. The only service they decided to undertake under capitation was out-patient, and I have to explain the reason as to why they did so. The contract we signed was with the NHIF. Madam Temporary Deputy Speaker, the contract provided that if my employees fell sick and got services from medical facilities, the NHIF would pay a number of listed benefits, all of which were based on the job groups of the employees. Due to the risk involved, capitation is a risk-sharing mechanism with healthcare providers. If it was fee for service, the NHIF would absorb the full risk of the medical cover. So, the NHIF chose capitation so that they may share the risk with the healthcare providers. They had done a pilot scheme for capitation. That pilot scheme was not done for the Civil Service Insurance Scheme. It was done for a universal healthcare scheme which would cover every Kenyan. Madam Temporary Deputy Speaker, when I appeared before the Committee as the Acting Minister for Medical Services I told the Committee that a universal healthcare scheme covering each and every Kenyan; if that is what is intended to be commenced now, then the capitation pilot scheme is inadequate. I told the Committee that it needs to cover more areas to see whether the 40 million Kenyans whom it may wish to bring or 50 per cent of them can be accommodated under capitation. That is what this Chairman keeps saying that I condemned capitation but he does not want to say is inadequate for universal. I did not say it is inadequate for 221,000 civil servants for which it was adequate. Wherever there are any weaknesses, the fee for service option was still available. In the contract with NHIF the word “capitation” does not appear. Madam Temporary Deputy Speaker, there are two contracts in this scheme. In my contract with the NHIF I pay the premium and you pay the medical expenses. On the contract between the NHIF and healthcare facilities, that contract, I am not privy to. I wait for performance at the end of that contract, whether my employees are satisfied or not. I did the survey and I tabled the report. The report they have given other than the recommendation that some people should be investigated, this is not superior to mine. Any hon.Member who wants can investigate what I did in February."
}