Hospitals in Kenya are turning away critically ill patients with chronic illnesses who depend on the National Health Insurance Fund (NHIF) for their treatment. This is due to a confusion between NHIF and private hospitals that has led to non-payment of bills by the government agency, with NHIF owing hospitals up to Sh12 million ($109,000), which has been accumulating since last year. The NHIF provides healthcare to most Kenyans, and with hospitals refusing to serve patients with NHIF cards, the situation has become dire for many.
Many hospitals fear that the system may end up not paying their claims and have therefore requested anonymity for fear of reprisals. The hospitals have declared that they will not serve patients with NHIF cards until further notice and until they receive a substantial amount of money from the NHIF. Hospital managers have voiced their concerns that they cannot run their day-to-day finances, including the purchase of consumables, with partial payments.
An insider told the Nation that the NHIF is broke, with the National Treasury owing it over Sh27 billion ($245 million), and counties are not remitting money to the NHIF, making it difficult for the fund to have money to pay hospitals. The situation is also exacerbated by the fact that the government is insuring the National Police Service, Kenya Prison Service, and Teachers Service Commission through private firms, which has confused the fund.
Private hospitals have appealed to NHIF to release payments to enable them to serve their clients. However, many hospitals are in debt, and the only way they can continue to provide quality healthcare to their clients and NHIF members is if the money is released.
The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has also voiced its concerns, with its secretary-general, Dr. Davji Atella, alleging that the government has been diverting over Sh20 billion ($182 million) annually from NHIF to private insurance companies, leading to the fund being defunded. He called on the government to pay what it owes if it wants to save the health sector.
The NHIF acting chief executive officer, Mr. Samson Kuhora, was unavailable for comment at the time of writing. The situation is unsustainable for most hospitals, and there needs to be a serious discussion to address the problem before it affects the entire health sector.