Nairobi Metropolitan Services (NMS) is proposing that all city residents on the National Hospital Insurance Fund (NHIF) use the cover only in public hospitals ostensibly to benefit such facilities.
The reason cited is that private hospitals benefit more from NHIF than public facilities. Whereas the fundamental intent of this argument is good, the silo approach is pedestrian.
Globally, emerging countries are driving a healthcare agenda towards achieving universal health coverage (UHC) whose tenets are equity, quality and increasing accessibility; both financial and geographic.
The model that is taking shape is that which focuses on primary healthcare (PHC) as a key cornerstone of healthcare.
In this approach, indigents are identified and their healthcare costs paid by governments through social insurance schemes. They receive services at specific PHC facilities. On secondary and tertiary services, public and private facilities complement.
One major misnomer is that private facilities are only the major hospitals located in large urban areas. No! Private facilities include nursing homes, cottage hospitals, rehabilitative and medical centres that complement public systems.
Therefore, in attempting to bar them, NMS would actually be stultifying UHC principles of increasing access to quality healthcare.
It is also important to recognise contributions by the private sector that shape the specifics of social insurance.
It is prudent that as brick and mortar expansions continue, internal efficiencies should be raised instead of stifling private facilities.
This will grow an inclusive healthcare market in Kenya.
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