Why Covid-19 incentives fall short of demand

Data on trends in positive cases projected from other countries suggest, the next two weeks to be when cases rise. So far, the Covid -19 response team has done a commendable job ensuring, public education, limited spread potential, security and preparation for anticipated increase in positives.

President Uhuru Kenyatta’s interventions to cushion Kenyan’s economically while commendable, are short on specific health sector support. Save for the Sh1 billion to hire medics, other measures are too general to impact hospitals’ operations.

Based on service provision, the private side actually serves most Kenyans. With ensuing uncertainty, limited operations and closure of some of these private facility services means patients now have few options to seek care. Operating as businesses, however, places them at the mercy of insurers and patients, many of who are now unable to pay. That despite the fact that they still have to continue paying salaries, rents and operation costs.

With many insurers including the National Hospital Insurance Fund (NHIF) struggling to pay on time, many private hospitals have not been paid their claims for quite a while. A few of the hospital administrators interviewed indicate over six months’ arrears owed them by the NHIF and close to three months by private insurers. Given the uncertain financial state, banks are not keen to lend to small and medium enterprises (SMEs) in the health sector, further curtailing funds to purchase personal protective equipment (PPEs) and medication whose costs have more than doubled.

The new curfew rules also make it hard for health workers’ commutes. Those using public service indicate they are now being forced to use taxis, tripling their commute budget.

Covid-19’s care needs specialised services, and the private sector has more specialists and is also better equipped for such services. Without State intervention, the private sector will have difficulty operating in this period.

Here are a few quick recommends for the government to look into.

The President needs to ensure NHIF expedites payment of all pending hospital claims. Prepayments are also not an unwise, as it will allow facilities to plan for the worse times coming. Private sector insurers should prioritise payment of medical claims above all other insurance classes. We are dealing with a medical issue and the 30 days contracted should be honoured.

County governments should pay owed salaries including arrears for health workers. It is worrying to have people go on strike over salaries at this time. Hired State staff could also be deployed in private facilities if these are overwhelmed by volumes but have equipment to handle the cases.

Any health centre on active duty in the pandemic ought to get a rent support from the government with a further five percent pay-as-you-earn (PAYE) reduction for health workers on designate Covid-19 care facilities.

Finally, an interest free loan fund for hospitals willing to invest in intensive care units.