Kenya stands at the exciting precipipus between our history and our increasing national income status and economic clout. Our GDP growth still booms as one of the world leaders. Our middle class bursts with hope and optimism, pushing down the dreams of economic prosperity to more and more Kenyans.
But what else do we aspire to achieve? Surely economic growth alone is but a means to an end. We want a happier Kenya. What makes us happier and more satisfied with our lives in our republic? Surveys show access to education opportunities, more breadth of job choices, more stability for our families, safety and security, and access for truly democratic political participation.
Interestingly, a major component of safety and security comes not only from our own physical safety and the absence of immediate or perceived harm from bandits, thieves, and crooks, but the well being from that ever core human emotion: safety from future illness.
Kenya champions a long tradition of togetherness and coming together during and after a crisis. But harambee fundraiser after harambee only provide stopgap measures on our collective national health journey. We prefer to be reactive as a nation rather than proactive. Uptake of private health insurance in Kenya still stands dismally low as the Kenya Integrated Household Budget Survey shows a health funding gap of 36 million Kenyans.
Then when sick, Kenyan health insurance covers only minimal amounts, with masses of exclusions. Get sick? You get dropped like a hot potato in the kitchen.
Several indigenous Kenyan NGOs, including Amref Health Africa, push a bright spot in our Kenyan health landscape: as well as our National Hospital Insurance Fund (NHIF). While still not perfect, NHIF saves thousands of lives per year—from life -saving cancer drugs to hospital stays to maternity cover.
NHIF represents Kenyans’ most widesweeping attempt at Universal Health Coverage. But we need it to reach higher levels to make the quality of service high enough to attract workers from other countries employed in Kenya. They should be able to choose Kenya in part because of the quality of our NHIF.
Better NHIF would mean lower health costs for Kenyan employers.
The World Health Report estimates that 20 to 40 percent of private health insurance gets eaten up and wasted in health systems. The United States represents a striking contrasting example of phenomenally high care but shockingly high wastage. The United Kingdom, on the other hand, provides free National Health Service health coverage to all citizens who earn less than Sh6.4 million per year, with their flat 20 percent income tax rate. Our high Kenyan personal income tax rate of 30 percent still does not provide universal health coverage.
So in our not-quite-yet quest for Universal Health Coverage, how does Kenyan medical insurance compare to America? A middle-aged employed professional worker in Kenya has their employer pay roughly Sh92,000- for Sh1.25million in cover, totalling about 7.3 percent cost per coverage. In the United States, a worker can purchase Sh100 million in coverage for a cost of Sh600,000, which is a dramatically lower 0.6 percent cost per coverage.
So our Kenyan coverage protects against common illnesses, but not against catastrophe. As our economic clout and prosperity grows, we will demand catastrophic coverage so that we do not have to die because of no cancer immunotherapy or heart and liver transplants. We will want more total rather than fake protection. Our growth service sectors, from technology to entrepreneurship to financial services, will all increase our demand for total health protection.
Universal Health Coverage also only works in tandem with top-notch teaching and referral hospitals. As NGOs promote awareness and uptake of NHIF at the grassroots, we need to decommoditise at the top end of our system. Healthcare management is not transactional as much as a team approach of multidisciplinary medical professionals. An individual's health does not exist in isolation. Comprehensive health networks with vast research and interconnected links must sit on top of the health system aspirationally.
New exciting treatments on the cutting-edge of the medical frontier at the Aga Khan University Hospital and new up and coming quality providers will continue to boost Kenya as a healthcare centre of excellence for our East and Central African region.
In the next 10 years, let us through teaching and research excellence and mass roll-out of Universal Health Coverage in our NHIF really put upward pressure and compete with Dubai, Bangkok, and Hyderabad to boost our economic prospects and our collective aspirations health and safety dreams.