Taxpayers will bear the burden of a separate medical insurance scheme for civil servants outside the troubled Social Health Insurance Fund (SHIF), a new proposal by the National Treasury indicates.
This comes even after the rollout of the new Social Health Authority’s SHIF, which the government has touted as a more comprehensive and superior scheme to the previous National Health Insurance Fund (NHIF).
SHIF has, however, been plagued by many challenges, resulting in some patients being required to pay out of pocket to foot their medical bills.
The proposed Public Officers Medical Scheme Fund will pay hospital bills for civil servants and disciplined officers once they exhaust their limits under the general SHIF scheme.
In the proposed regulations published by Treasury Cabinet secretary John Mbadi, the scheme is set to be funded mostly from taxpayer money allocated by Parliament.
“The fund shall consist of the amount of money appropriated by the National Assembly, the contribution made by the ministry responsible for public service, and any other employer who has opted to contribute to the scheme out of money payable to public officers as medical benefits and grants and donations,” said Mr Mbadi.
According to the proposed regulations, the special State officers’ scheme will cover outpatient, inpatient, dental, optical, and annual medical check-ups for up to six dependents, but the officers will not need to pay anything for it.
It also offers other benefits under SHA, such as road ambulances, emergency air rescue services, overseas treatment, and life and last expense covers, which, in the private sector, are only available on high-end insurance schemes.
Select committee
The scheme is designed to replace the comprehensive Medical Insurance Scheme for Civil Servants and Disciplined Services, which was wound up alongside NHIF during the recent transition, having existed since January 2012.
The scheme will also be administered by SHA under the supervision of a select committee composed of principal secretaries for the Treasury, Medical Services, and Public Service, along with SHA board members.
For the rest of Kenyans, however, the benefits and limits under SHA will be equal irrespective of their monthly contribution to the national insurance scheme.
Under SHA, ordinary Kenyans are meant to enjoy outpatient, inpatient, optical, and dental cover. There is also renal care, oncology, maternity, mental health and chronic illness provision, but all are subject to specified limits.
The public officers’ scheme is set to commence during the current financial year, but the proposals have just been put forth for public participation, which is set to end by November 18.
“The regulations may be modified in light of the comments received before being published in the final form,” Treasury said in a public notice published Wednesday.
It is not clear whether the funds meant for the scheme have already been budgeted for, or if they will be presented to the lawmakers through the second supplementary budget expected to be tabled early next year.
