HTTP 200 OK
Allow: GET, PUT, PATCH, DELETE, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept
{
"id": 90613,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/90613/?format=api",
"text_counter": 247,
"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": "With regard to in-patient services, the current comprehensive services will be enhanced to include the following:- (i) Inclusion of dialysis and subsidized transplant costs. Currently dialysis is costing Kshs15,000 in private hospitals and Kshs5,000 in Kenyatta National Hospital (KNH). It will now be covered by the National Hospital Insurance Fund (NHIF), including transplant. At the moment, transplant of kidneys at the KNH costs Kshs800,000. In India, it costs Kshs2 million. I am ready to table in this House documents showing the amount of money the Government has been spending in the form of ex-gratia to take our people for treatment abroad. In other words, this means exporting our pathologists. (ii) Inclusion of common surgeries and comprehensive cover. All these will be given by the NHIF given the following contributions by members. I want Members to listen carefully because there has been a misconception in the Press that everybody is going to pay Kshs2,000. That is not true. The payments are graduated now from those earning less than Kshs5,999 to those earning over Kshs100,000. I want to read very carefully the brackets so that we understand. For those earning less than Kshs5,999, they will pay Kshs150 a month. In other words, if you are a family of five and you pay Kshs150 a month, you will be paying an equivalent of Kshs5 a day for your whole family to get access to those services I have mentioned. Those earning from Kshs6,000 to Kshs7,999 will pay Kshs300 a month while those earning Kshs8,000 to Kshs11,999 will pay Kshs400 a month. For those earning Kshs12,000 to Kshs14,999, they will pay Kshs500 a month; Kshs15,000 to Kshs19,999 - Kshs600 a month; Kshs20,000 to Kshs24,999 - Kshs750 a month; Kshs25,000 to 29,999 - Kshs850 a month; Kshs30,000 to 49,999 - Kshs1,000 a month; Kshs50,000 to 99,999 - Kshs1,500 and those earning Kshs100,000 and above will pay Kshs2,000 a month - That is you and I. The self-employed people will pay Kshs500 and the indigents or voluntary contributors will pay Kshs300 a month. Mr. Deputy Speaker, Sir, at the moment, in terms of national statistics, people who are in employment (not businesspersons or those privately employed) and earning Kshs100,000 or more in Kenya are only 46,000 Kenyans. The reason the private medical health providers are complaining is because they think that since the NHIF will charge only Kshs2,000 while they charge Kshs12,000 people will migrate from that market to the services provided by the NHIF. However, these are the rules of a free market. It is about competition. I do not think that the NHIF should be excluded from competition simply because they are charging people less to give them better services. I have been reading complaints by the private health providers and I think that it is now the tyranny of the private sector over the public sector. Here in Parliament we represent the poor of Kenya and I will stand to speak on behalf of Kenyans rather than pander to the greed of the private sector. Mr. Deputy Speaker, Sir, with increased participation of the NHIF in the financing of health-care in Kenya, currently it is estimated that the total health-care expenditure is Kshs150 billion out of which the NHIF contributes 4 per cent mainly due to low contribution rates and low coverage. The low coverage is compounded on the fact that the Fund is unable to offer broader products to meet customer expectations due to inadequate finances. Out of the Kshs150 billion health-care expenditure, 26 per cent come from your pocket expenses. In other words, you are frequently called to Harambee to contribute to pending bills of patients in the hospitals. You are becoming the insurer and not the NHIF. This move is expected to liberate you from being the insurer of your constituents and transfer that responsibility to a Government body. When the NHIF rolls out the out-patient cover, it will inject an additional Kshs10 billion to the health sector. This will increase the Fundâs contribution from the current 4 per cent to 21 per cent of the total health-care expenditure. As a result, it is envisaged that the Government will increase its participation in preventive and promotive health-care from the current 12 per cent to 25 per cent. The new contributions will reduce the household expenditure on health from Kshs54 billion to approximately Kshs32 billion or from 36 per cent to 21 per cent. At the moment, households are spending from their income, 36 per cent to take care of their health. We want to reduce that to 21 per cent. Our long-term aim is that by 2030, if we have to meet the goals of Vision 2030, we should have reduced that to 0 per cent. However, we cannot do that at once since the wealth of this nation and that of individuals does not allow it. Mr. Deputy Speaker, Sir, further, because of removal of financial barriers and enhancing access, there will be a reduction of self-medication which impacts negatively on the health of Kenyans. They will also be more efficacious in providing drugs and managing diseases. With increased contributions, the Fund will be able to expand its product line by extending the current benefits to include out-patient cover. Currently, the cost of out-patient care in Kenya is approximately Kshs16 billion annually. Currently, the NHIF does not contribute to out-patient care. However, with increased premiums, the Fund will contribute 18 per cent on the entire out-patient care expenditure or Kshs11 billion rather than zero at the moment. We, therefore, expect the health sector to improve over the next five to ten years, rather than go down. Let me assure you that, that cannot happen unless we, in Government, improve health infrastructure. At the moment, I am working on 63 districts and sub-district hospitals to improve the infrastructure. We have already completed work at the Kisii District Hospital and Kericho District Hospital. We are in the process of completing work in Embu and Meru. On Monday, we started expanding Othaya District Hospital. However, I will be able to make a Statement to the House in the next four weeks with regard to which projects we have completed to bring our hospitals to modern standards where they can use modern equipment and improve diagnostic services. In conclusion, the introduction of out-patient service not only complies with the provision of the NHIF Act, the new Constitution of Kenya and Vision 2030, but also meets the aspirations of the Millennium Development Goals (MDGs). This process has taken four years. It has not been instantaneous, rather it has been consultative and major stakeholders have bought into it. The burden of disease will reduce as this initiative promotes primary health-care. The service is also very marketable and is expected to help in increasing the coverage through introduction of a rate that allows the indigent to access health-care through a sponsored programme. The revision of the contribution rates is long overdue as the current rates were established 20 years ago. It should be understood that even without the introduction of the out-patient cover, inflation and other economic factors have greatly eroded the purchasing power of the scales set out in 1989. Thank you very much."
}