Kenya: New Health Tax Shocker On the Way
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The Nation (Nairobi)
5 September 2008
Posted to the web 6 September 2008
Samwel Kumba
Nairobi
Working Kenyans will soon have to pay medical bills for the unemployed, if a new plan to help the poor access health care is adopted by the Government.
And it means a massive increase in health contributions by people with jobs.
Currently workers pay a maximum of Sh320 a month while voluntary contributors give Sh160.
But details of the new scheme obtained by the Saturday Nation show contributions will be paid as a percentage of earnings -- between two and 2.75 per cent.
This means people earning Sh20,000 a month will pay Sh400 while those earning Sh100,000 will have to part with about Sh2,500 a month.
New scheme
Under the new scheme a sick person will need only Sh20 for treatment at a public hospital.
The money, currently paid in government clinics and hospitals as the "card fee", will grant automatic registration to the proposed new National Hospital Social Insurance Fund (NHSIF).
The new scheme is intended to cushion the health fund, a State corporation which is finding health costs too much to finance compared with members' contributions.
If approved, the scheme will roll out at a time when a majority of Kenyans, especially those living in the rural areas, are unable to access basic health services.
It will also go a long way towards boosting the Government's goal of health for all Kenyans by the year 2020.
Medical Services minister Anyang' Nyong'o confirmed that the new scheme's main goal was to make health care accessible to all Kenyans.
However, he said he could not discuss details before presenting the proposal to the Cabinet.
Prof Nyong'o said: "Our health system is a major contributor to the widening gap between the rich and the poor. This scheme will to a large extent address this anomaly."
The minister said extra resources will be required to extend free medical services to those who cannot afford it.
"Our concept will bridge the disparity that exists in health care access between the haves and the have nots. We cannot achieve Vision 2030 with the current vulnerability of the poor," he said.
This concept is, however, not new in the local health sector. Four years ago, attempts by the then Health minister Charity Ngilu to introduce a similar plan were thwarted when President Kibaki rejected it.
Prof Nyong'o, who was then minister for Planning and Economic Development, had played a key role in drafting of the Bill.
Then Finance minister David Mwiraria supported the President saying the Government could not afford to finance the scheme.
It also came under sharp criticism from the private sector as it compelled employers to remit money to the fund. The Kenya Medical Association also expressed reservations about its implementation.
The new scheme which is set to be tabled before the Cabinet any time now, is an amended version of the 2004 plan.
Whereas the previous proposal envisaged a new Bill for a compulsory and comprehensive social health insurance scheme which would have compelled employers to contribute to the scheme, the new one exempts employers.
Another change is that instead of workers contributing fixed amounts, the new contributions will be calculated as a percentage of each individual's earnings.
Contribute
"This means those with higher salaries will contribute more to the fund than those who earn less," Prof Nyong'o said. The scheme, however, proposes a limit up to which those with higher salary scales can pay.
By exempting employers from making payments, Prof Nyong'o said it will mean they will continue with existing medical schemes for their staff.
This means some workers will contribute to the fund but they will not be able to take advantage of its benefits, except as in-patients.
Relevant Links
The scheme projects that 65 per cent of Kenyans will be able to access health care seven years from now. The demand for the rest will be catered for in the subsequent five years.
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