Civil servants face medical crisis as insurance expires

Hundreds of thousands of civil servants and their families across the country are in trouble because their comprehensive health insurance contracts are managed by the state. National Hospital Insurance Fund (NHIF) It will expire on June 30, 2024.

Those most likely to be affected are those admitted to hospital or receiving treatment locally and overseas, with NHIF providing Social Health Insurance Fund (SHIF)” the Civil Service Union said yesterday.

Civil servants who are seriously ill and undergo weekly treatments such as dialysis, chemotherapy and radiotherapy may also be affected.

The Kenya Union of Civil Servants (UKCS), which represents civil servants, has now urged the government to move quickly to ensure that services are expanded while the insurance procurement process for the 2024-25 financial year continues.

Cabinet Secretary for Health Susan Nakumicha and Chief Secretary Mary Muthoni assured the public that their NHIF insurance would continue after July 1, but union members warned that it was unclear what would happen to those who had signed enhanced insurance contracts with fixed end dates, such as civil servants.

“We need clear answers to allay doubts among members,” Judy Wangari, deputy treasurer of the Kenya Union of Public Servants (UKCS), said in a statement on June 28.

Unlike regular insurance, members of the enhanced plan can access hospitals under comprehensive or non-comprehensive contracts, depending on their personal allocation.

“General hospitals provide all-inclusive services in all packages to enhanced scheme members at no cost (admission and discharge). Services are covered at no out-of-pocket cost,” the NHIF guidelines show.

Those who receive a higher allocation can also access non-general hospitals on a fixed-fee basis.

Even more confusing is that Public Service Department Tenders have been called for health insurance for civil servants and disciplined forces, with a deadline of July 5, a few days after the contract expires.

UKCS also recommended that monitoring and evaluation reports of contracts with NHIF be considered when awarding new contracts and that current benefit packages be maintained as members expect service levels to improve, not decline.

“A healthy and vibrant public service means better government services,” Ms Wangari said in the statement, stressing the importance of addressing the looming health care crisis.

The rollout of SHIF has been slow due to technical challenges and a lack of clarity on the system which has slowed Kenyans to sign up.

Yesterday, CS Nakhumicha said self-registration Social Health Administration (SHA) It will start from July 1, 2024, while NHIF contribution will continue till the rollout of Universal Health Coverage (UHC).

A committee appointed by the Ministry of Health recently recommended suspending the scheme so that solutions can be found to address the challenges.

“We have asked ICT experts to come up with alternatives to the ICT system for SHA, especially in terms of registration and payment of fees,” the committee said in its report.

“An alternative solution is needed which also includes revoking the SHA regulations and using the NHIF system, the latter has financial implications. The nature of the current NHIF system licence and contract needs to be updated.”

They cited a pilot in Marsabit County that the report said revealed significant deficiencies in the technology infrastructure.

According to Afya House, the government needs at least Sh5 billion to build ICT infrastructure for SHIF.