Health

NHIF risks losing power to cut benefits in Senate push

nhif-ceo

NHIF chief executive officer Peter Kamunyo. FILE PHOTO | NMG

john-mutua-img

Summary

  • The Senate said allowing the NHIF board to single-handedly reduce the benefits will expose vulnerable patients suffering from chronic diseases to financial strain in footing high costs o treatment.
  • NHIF plans to cut average payout for renal dialysis to Sh6,000 from the current Sh9,500 in a move aimed at reducing bills for the weekly procedure by Sh1 billion annually to Sh2.7 billion.
  • NHIF chief executive Peter Kamunyo has in the past said that a significant number of patients with chronic illness are joining the fund after falling ill.

The National Hospital Insurance Fund (NHIF) could lose powers to cut benefits offered to contributors if MPs adopt proposals fronted by Senate in a bid to protect patients from chronic illnesses.

The Senate said allowing the NHIF board to single-handedly reduce the benefits will expose vulnerable patients suffering from chronic diseases to financial strain in footing high costs o treatment.

The proposal comes at a time the NHIF has disclosed plans to reduce benefits for renal dialysis and major surgeries in a cost-cutting push amid opposition from a lobby.

NHIF plans to cut average payout for renal dialysis to Sh6,000 from the current Sh9,500 in a move aimed at reducing bills for the weekly procedure by Sh1 billion annually to Sh2.7 billion.

“Arbitrary changes to existing health benefits packages for patients with chronic disease by the NHIF was likely to expose patients and their families to suffering, catastrophic health expenditure and increased morbidity and death,” the committee says.

“The committee thus observed that provisions should be made to prevent the NHIF board from arbitrarily withdrawing existing health benefits for patients with chronic illnesses.”

Renal Society of Kenya, a lobby for kidney patients opposed NHIF’s push saying that the insurer should rethink the decision.

Kidney patients are put on lifelong treatment and undergo three dialysis session in a week, with the lobby adding that the Sh6,000 will be insufficient even in low-cost public hospitals.

NHIF chief executive Peter Kamunyo has in the past said that a significant number of patients with chronic illness are joining the fund after falling ill.

“We have patients paying Sh6,000 annually and receiving benefits of nearly Sh1 million per year. This is a burden to NHIF,” Dr Kamunyo said.

Senate’s proposal is contained in its review of the government- backed National Hospital Insurance Fund (Amendment) Bill.

MPs will debate and vote to accept or reject the proposal when they resume sittings next month.

Other benefits that the NHIF has targeted for reduction includes major surgeries and diagnostics tests such as MRI and CT-scans, a move that will see patients top-up their medical bills.

The maximum cover for MRI scan will be reduced to Sh9,600 from the current Sh15,000 per session while settlement of CT-scans is set to be capped at Sh6,000 from Sh8,000.

NHIF reckons that the reduction of benefits payable will reduce hospital payouts by at least Sh2.9 billion in the year to June.

[email protected]