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{
"id": 90601,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/90601/?format=api",
"text_counter": 235,
"type": "speech",
"speaker_name": "Prof. Anyangâ-Nyongâo",
"speaker_title": "The Minister for Medical Services",
"speaker": {
"id": 193,
"legal_name": "Peter Anyang' Nyong'o",
"slug": "peter-nyongo"
},
"content": " Mr. Deputy Speaker, Sir, hon. Members will recall that in 2004 the Government presented to this House a Bill on National Social Health Insurance in Kenya with the main aim of providing quality health-care to all Kenyans. This Bill never came into law because there were issues that were thought not to have been fully considered; more importantly, its sustainability within the Kenyan situation was doubted. As a result of this setback, the then Ministry of Health in 2007 invited stakeholders to discuss and agree on how to develop a more sustainable medium to long- term health-care financing strategy that would address the needs of all Kenyans, especially the poor. This was later reinforced by the Kenya Vision 2030 that called for the development of an equitable and affordable health-care system of the highest quality. The Vision 2030 further called for the shifting of resources from curative to promotive and preventive health-care. The Vision also recognized a healthy workforce as a prerequisite for socio-economic development of the country as had been observed in the economic strategy recovery paper that I developed when I was the Minister for Planning and National Development in the year 2003. Subsequently, a broad-based task force was established to collect evidence for the development of the strategy. The task force commissioned a number of studies to provide the necessary information. These studies included the National Health Accounts for the Year 2005/2006, the Costing Study and Model, the Public Expenditure Tracking Survey as well as the Annual Ministerial Public Expenditure Reviews among other activities. Mr. Deputy Speaker, Sir, the results from some of the surveys do indicate that households contribute 36 per cent of total health expenditure, mainly through out-of- pocket spending, while the Government and donor contribution is 29 and 31 percent respectively. Although the Government budget has increased in absolute terms, it has varied between 8 per cent and 5.2 per cent between 2004 and 2010. These levels remain well below the Abuja Declaration commitment of 15 percent of public expenditure on health. The results further indicate that the poor utilize fewer health services as they are less likely to seek treatment when ill compared to the better off. Those who seek health- care leave huge unpaid bills in our health facilities. At the moment, the unpaid bills amount to a total of Kshs800 million in all our hospitals, and that money has to be found somewhere else. They are, therefore, lucky to have the National Hospital Insurance Fund, which was established several years ago, to ensure the health of Kenyans, or so that they can have access to health-care without leaving huge unpaid bills in the hospitals, thereby, grounding the work of these hospitals and making it difficult for the Government to find year after year, the money that is needed to take care of the health of Kenyans. Mr. Deputy Speaker, Sir, I would therefore, like to concentrate now on the initiatives that the National Hospital Insurance Fund has taken to enhance health insurance, and to ensure that Kenyans, both rich and poor, can have access to health-care. The National Hospital Insurance Fund is a national medical insurance fund that is managed by a board of management, whose membership is drawn from major stakeholders. Members of the board of management include the following:- a chairman appointed by His Excellency the President, a representative from the following organizations and societies: the Central Organization of Trade Unions of Kenya, the Kenya National Union of Teachers, the Federation of Kenyan Employers, farmersâ unions, civil society, the Association of Kenya Insurers, the Permanent Secretaries in the Ministries of Medical Services, Public Service and the Treasury, the Director of Medical Services, the Chairman of the Kenya Medical Association and the representatives of the faith-based charitable health providers. The National Hospital Insurance Fund is, therefore, a statutory scheme for the salaried workers and voluntary for the informal sector workers. It provides a family- based cover for the contributor, spouse, children and dependent parents or guardians. At the moment, the National Hospital Insurance Fund covers 23 percent of Kenyan population. Members and workers make monthly contributions that are based on a graduated contribution scale that was set up and operationalised in 1989. This two decade old scale gives the lowest contribution at Kshs30 for those earning Kshs1000 per month, the highest contribution being Kshs320 for whoever earns more than Kshs15,000. Members in the informal sector pay Kshs160 per month."
}