No NHIF cover for Covid-19 patients, Kagwe declares

Thursday, November 12th, 2020 00:00 |
Health CS Mutahi Kagwe when he appeared before Health Senate committee, yesterday. Photo/PD/SAMUEL KARIUKI

Hillary Mageka @hillarymageka

Covid-19 patients will now have to foot medical bills from their pockets after the government said the national insurer cannot meet its costs.

Health Cabinet Secretary Mutahi Kagwe said the National Hospital Insurance Fund (NHIF) cannot afford to foot the medical costs of Covid-19 patients in public and private hospitals.

“It is not practical for NHIF and private insurance companies to cover pandemics,” Kagwe told a Senate committee on Health yesterday.

“The cost burden of financing Covid-19 testing and treatment for NHIF beneficiaries both in the national scheme and the enhanced medical schemes would not be financially viable since it was not envisaged in the current NHIF premiums computation and the existing benefits package,” he added.

Kagwe’s announcement comes in the wake of reports that several public hospitals were slapping Covid-19 patients with huge medical bills following delays by the government to remit NHIF contributions.

Reports from public hospitals indicate that the government stopped footing bills for Covid-19 patients back in June, though the Health ministry has vehemently denied the claims.

It costs Sh21,359 to treat an asymptomatic Covid-19 patient in a government hospital a day and Sh21,361 for a patient with mild symptoms.

Patients with severe cases are charged Sh24,705 a day while those requiring Intensive Care Unit (ICU) services are charged Sh51,684 daily.

Medical economists have been urging the government to urgently develop a sustainable financing model for virus patients given the fact that more than 70 per cent of Kenyans can hardly afford the amounts of money involved.

Statistics from the National Emergency Response Committee on Coronavirus show that per patient, health system costs for  coronavirus management are driven by Personal Protective Equipment (PPE) costs, which account for approximately 65 per cent of total costs.

Yesterday, however, the CS maintained that the government had stepped in to subsidise or even write off medical bills incurred by poor Kenyans who had contracted the virus.

Besides the fact that globally, pandemics and epidemics are excluded from insurance cover, NHIF’s own service contracts and the projected high number of infections have made it impossible for it to meet the cost – from testing, acquisition of PPEs to isolation and treatment.

“NHIF would not have a financial obligation under globally recognised best practices, or its present model of operation, to finance the testing or hospitalisations related to this or other epidemics or pandemics,” the CS explained.

Global pandemic

The World Health Organisation (WHO) declared Covid-19 a global pandemic on March 11, two days before Kenya recorded its first case.

Only a few private insurance companies offer cover for Covid-19 patients, with majority of the firms having issued an alert to their clients, stopping the obligation.

Kagwe’s declaration is a heavy blow to thousands of poor Kenyans who will now be forced to dig deeper into their pockets to pay for their treatment. And this comes at a time the disease is fast spreading in rural communities where incomes are low.

“NHIF would, therefore, request the committee to consider the global best practices and sustainable model of managing pandemic responses through a centrally coordinated and financed model,” the CS told the committee chaired by Trans-Nzoia Senator Michael Mbito.

He, however, disclosed that in instances where some patients have demonstrated inability to foot their bills, the government has stepped in and written off the bills, mainly in public hospitals.

Regarding private hospitals, there is no enabling legal framework to cushion patients, Kagwe explained.

NHIF Chief Executive Peter Kamunyo, who accompanied Kagwe, reiterated that it would not have been financially viable for the  national insurer o finance treatment of corona for the current national or enhanced medical scheme members, or a national Covid-19 response modelled under the Universal Health Coverage, without external financing specific to the reimbursement of the pandemic related expenses, and at specific hospitals.

The committee had summoned the CS and the NHIF top brass following concerns that the public insurer and private insurance firms had refused to pay for treatment of their members diagnosed with the contagion.

Members of the committee put Kagwe and the NHIF boss to task, demanding to know why the insurer and private insurance firms were not covering Covid 19 patients yet they do not treat the disease itself but related ailments.

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