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{
    "id": 90624,
    "url": "https://info.mzalendo.com/api/v0.1/hansard/entries/90624/?format=api",
    "text_counter": 258,
    "type": "speech",
    "speaker_name": "Prof. Anyang’-Nyong’o",
    "speaker_title": "The Minister for Medical Services",
    "speaker": {
        "id": 193,
        "legal_name": "Peter Anyang' Nyong'o",
        "slug": "peter-nyongo"
    },
    "content": " Mr. Deputy Speaker, Sir, the questions are very good. Let me respond to them systematically as they were asked. The ailments going to be covered by outpatient cover is something that we have tested in a pilot project that I launched in Mumias in February, 2010. So, we have got the results back and we know what it costs to cover them and whether we can do so. So, it is not something that we are now guess-working. It is something that is scientific and we know that if we collect this money, the NHIF will sustain the coverage. Mr. Deputy Speaker, Sir, secondly, people have asked whether this is now a closed shop that we cannot cover others. We are covering the broadest spectrum possible diseases that Kenyans suffer from. If you ask me, 75 per cent of those who go for outpatient care go to hospitals either as a result of malaria or infectious diseases. So, once you cover those broad spectrum diseases that are common to Kenyans, you will know, by doing a further actuarial study, whether we can cover more. That is after we have completed the project. I will tell you that NHIF will cover everything regarding in- patient. There will be no discrimination in in-patient care. According to actuarial studies, once out-patient care is covered, we know that we will be doing reasonably well. Hon. Shakeel has asked a very important question. He asked: To what extent are we sure that NHIF is competent to do the work that it is supposed to do? Hon. Shakeel also implied that if, indeed, this contribution is being enhanced, whether NHIF has the internal capacity to manage the contributions and dispense them effectively. It is precisely because of that, that, as a Minister, I contracted the International Finance Corporation(IFC), which is a branch of the World Bank, to do a management audit of NHIF as this is launched. I would like an organization that performs its duties effectively. Reading the Press, there is a misconception that IFC is doing an actuarial study. IFC is doing a management audit. The actuarial work was done by Alexander Forbes before we rolled out the out-patient pilot project. It was on the basis of Alexander Forbes actuarial work that we arrived at the categories of contributions that we are now making. That leads me to hon. Karua’s question: Why will people earning Kshs100,000 and more be paying Kshs2,000? We were advised by the actuarial work that once you reach Kshs100,000 and you contribute Kshs2,000--- Majority of those who earn Kshs100,000 and more opt to be covered by private health providers. For example, here in Parliament, we are covered by AON-MINET. Unfortunately, when it comes to in- patient care, most hospitals ask you whether you are covered by NHIF. They first charge NHIF before they go to AON-MINET, which is really unfair. In any case, we are talking about a market of about 46,000 people. If you begin having over 200,000, that means that you will be managing a very small population. So, the overhead cover of trying to do little things may be more costly. We were advised by the actuarial scientist to put Kshs2,000 for people earning Kshs100,000 and more. If, indeed, in the operationalization of these scheme we find that we should again categorize them further and it becomes actuarially advisable, we will do so. However, at the moment, I can only go by the actuarial advice and do the way I have done it. This is something that is not cast in stone and in real practice, it can be changed. Hon. Karua asked something which was a subject of a point of order. She asked: Why did we not bring this issue to Parliament first? Parliament, in its wisdom, many years ago, passed an Act in this House which empowered NHIF to vary the rates as it is necessary. This thing is being done in accordance with the law that was passed by this House. It is in the Act that established NHIF. We can review that Act. However, at the moment, the Board is within its powers to do what it has done and to gazette that. The Board is required to gazette the contributions. Now, we can bring the Kenyan Gazette to this House and legal minds would debate on the issue. However, we need to look at the NHIF Act to see where we get all the powers. Hon. Ms. Karua also asked about the poor. Yes, there is a category of Kshs300 for the poor or the indigents. NHIF is doing what has been done elsewhere; that when I, Prof. Anyang’-Nyong’o contribute Kshs2,000 for both in-patient and out-patient cover, I also carry an AON-MINET card so that when I go for out-patient at the Nairobi Hospital, I will charge AON-MINET and not NHIF. That way I will give NHIF the opportunity to use my money to cover the poor. That is my contribution to social solidarity. NHIF would be in a position--- An experiment has been done to find out who the indigents are and, therefore, those who would be covered by NHIF at a rate of Kshs300 a month would not need to get that money out of their pockets. That is what we are doing to cover the indigents. The NHIF Act under the current practice allows NHIF to have self-employed contributors. Indeed, in the statistics of NHIF, we have many self employed people who are contributors to NHIF. At the moment, we have about 2.8 million contributors to the NHIF and thereby, NHIF covers a population of over 11 million. Part of that population is self employed."
}