The fallout from revelations of underhand tactics employed by private hospitals to irregularly milk extra cash from patients has seen insurance companies refuse to honour future bills in the affected institutions.
The recent saga involving a private hospital in Nairobi has exposed a deeper malaise that has lent weight to longstanding concerns over the cost and treatment practices of private hospitals in pursuit of profits.
It is sad that these practices have been going on right under the gaze of the Health Ministry and the Kenya Medical Practitioners and Dentists Council, at a time when Kenyans are struggling to access and afford quality healthcare.
It is in such times that medical insurance comes in handy, offsetting large bills that would otherwise cripple many financially, especially in a country where public health facilities have not been up to the required standard.
This is a system that is to some extent based on trust — where the insurers trust hospitals to be fair in pricing their services, and the hospitals treat patients knowing they will be paid by the underwriters. When one of these aspects is breached, it is the patient who suffers.
The Ministry of Health and the Kenya Medical Practitioners and Dentists Council should therefore move with speed to conduct a thorough and fair audit of all private and public hospitals in regard to treatment, admission and prescription of drugs and how these services are offered and costed.
In public hospitals, the audit should also cover the questions about availability of drugs bought using tax money, where many are referred to private chemists to buy medicine that should ideally be readily available in these hospitals. Such an investigation, if done correctly, will weed out rogue actors and restore public faith in these institutions and in the long run also guarantee the business viability of hospitals.
If not done urgently, Kenya will continue to see large outflows through medical tourism abroad where hospitals charge fairly for services and treatment is not based on greed and fattening the bottom-line.
It is also important for the government and the medical board to appreciate that underhand practices such as the ones alleged at Nairobi Women’s Hospital are a drain on the public purse, due to escalated claims on the State-managed NHIF. In the long run, such dealings make a mockery of the government’s desire to roll out universal healthcare, whose success or failure will depend a lot on goodwill from all actors in the health sector.
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