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Columnists

Healthcare is funded by the taxes we pay

A nurse attends to a baby at the Kenyatta National Hospital. FILE PHOTO | NMG
A nurse attends to a baby at the Kenyatta National Hospital. FILE PHOTO | NMG 

President Uhuru Kenyatta’s Big Four agenda identifies affordable healthcare for all as one of the four pillars that will drive the country’s economic development. This is a commendable move as the correlation between affordable healthcare and economic development is well documented.

Data from the Ministry of Health indicates that medical bills are the single biggest cause of the poverty gap in Kenya, pushing over 1 million people below the poverty line annually.

This exacerbates the cycle of inequality in a country where 11 million people live in extreme poverty, according to World Bank estimates.

Against this backdrop, affordable healthcare is a powerful catalyst for economic growth. However, for Kenya to achieve this goal, we need to be more strategic in our approach.

Currently, the quest for affordable healthcare is narrowly focused on non-strategic declarations on “free healthcare” initiatives.

Declarations are not strategy. For affordable healthcare in Kenya to become a reality, it needs to be strategically aligned with the broader UN-driven goal of achieving Universal Health Coverage (UHC) of quality access and affordability for all by 2030 with evidence based approaches and continuous learning and adapting to context.

The global push for UHC by 2030 is focused on ensuring access to quality healthcare for all without financial burden. A critical part of this global strategy is financing healthcare through domestic resource mobilization.

This means that countries ought to rely more on taxes and national health insurance schemes and less on donor funding and out-of-pocket expenses to financing their healthcare.

Slogans such as “free healthcare” create the impression that Kenyans do not pay for healthcare, despite the fact that they do through taxes and NHIF deductions. This slogan also discourages the public from demanding better access and higher quality since services are “free.”

Politicians typically play along, despite knowing better, as this is a quick way to fill the vote basket. We must fight this perception of free healthcare and remind our people that healthcare is funded by their taxes. It is tax-funded not free.

Healthcare is not a gift granted by a benevolent government, but a right that is clearly defined in the Bill of Rights in Chapter 4 of the Constitution.

A rights-based approach to UHC will provide a stronger legal framework for citizens to demand for better healthcare. This is the global approach to UHC that currently lacks.

Part of our advocacy efforts involve educating the public on strategic prioritization in healthcare funding. In other words, we are helping Kenyans understand why remunerating the community health worker (CHW) in Makueni or Kakamega is a greater priority than modernising clinics in urban centres through installation of MRI machines and other expensive equipment.

Kenyans should lobby their leaders to ensure that spending in healthcare is aligned to the broader objective of ensuring access to quality healthcare without financial burden. Healthcare is not free. It is paid for by our taxes.

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