Every evening people gather at All Saints, Garden Square, KICC and many other joints in Nairobi as well as other urban centres even in villages to raise funds. In most cases, the funds are for either sick or deceased persons whose relatives cannot raise the medical bill to enable them proceed with other arrangements.
A number of research papers show that besides the culture of poverty, corruption and healthcare are major causes of poverty in Kenya. The problem affects both the insured (less than five per cent of the population) and non-insured alike.
Most Kenyans are fatigued by these endless fund raisers. Donations get smaller by the day leaving families with huge debt burdens. Those who are lucky borrow or sell an asset to pay for their loved one’s healthcare. Insurance though helpful has limits. Families have been left destitute as costs escalate.
Application of Information Communication Technologies (ICTs) and minimal legislation may help reduce the burden on citizens. A pilot project by Accenture at the Kenyatta National Hospital shows that if processes are automated, as much as 40 per cent of the cost can be saved.
Much of these costs are attributed to inefficiencies, poor processes, opaque systems and lack of diligence on the part of care givers. Billing by most hospitals is shrouded in secrecy.
A mark-up on supplies and medicines is as high as 200 per cent. A dose of pain killers can cost you as much as one month supply of the same from a pharmacy. Best practice with proper regulation; such mark ups are capped to protect patients from exploitation. Minimal legislation could enable availability of data just like banks do. This will effectively end medical billing secrecy.
In both private and public hospitals, there is no reason why procurement should not be automated and data made available to public.
Processes and procedures in hospitals can be standardised to enhance efficiency and care for patients at affordable costs. Lower cost will lead to more patients that will enable economies of scale to kick in and replace the current elitist care.
Further insurance will be accessible to many and reduce the slide into poverty by relatives of the sick.
Our doctors too should be cost conscious by leveraging on technology to cut cost. In India both public and private hospital doctors lead in the discourse of technology and cost cutting as vital strategic elements.
More than two-thirds of the Indian population lives on less than $2 a day and 86 per cent of health care is paid out of pocket by individuals. Although our health demographics are similar to India, Indians enjoy relatively lower cost of healthcare.
The spread of fibre optic cables throughout the country should help reduce the cost of deploying radiologists throughout the country by centralising capacity to offer high quality services at lower cost. Further, the same infrastructure should be used to offer tele-health services and eliminate unqualified health personnel from the healthcare systems.
The future health management will be dominated by internet of things where practically everything including health devices will have a virtual representation. For example, there will be no need to see a doctor to check on your pacemaker.
On legislation, our parliament needs to borrow a leaf from the US and other countries that have succeeded with providing universal healthcare coverage. Their focus should be on how to build inclusive healthcare institutions that would eventually eliminate the slide into poverty by the affected citizens and protect patients as in the US.
On March 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA) simply referred to as the Affordable Care Act (ACA) or Obamacare.
The law represents the most significant regulatory overhaul of the United States Healthcare system. It aims to increase the quality and affordability of healthcare, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of healthcare for individuals and the government.
The benefits leveraging on technology in healthcare, are enormous and range from operational efficiency, easy process verification for key procedures and checkpoints, improved productivity among medical personnel, complete compliance with regulations and adequate documentation, and better management or optimisation of available resources.
Dr Ndemo is a former permanent secretary for Information and a lecturer at the University of Nairobi