In Summary
  • Doctors have been in the news in the past week for two different reasons: Parliament’s intention to control doctors’ fees and a decision by a corporation intending to restrict doctors to prescriptions of generic drugs for its insured patients.
  • Their argument so far is correct, except that the medics expressed an opinion then follow up with the claim that adoption of universal health services model is the solution to the challenges in Kenya’s medical services provision.
  • These doctors are right in opposing price controls for professional services but their reason for it is informed by their self-interest to drive employment of doctors in the public sector.
  • The doctors’ opposition to a proposal by an insurance firm that they only prescribe generic drugs, which are cheaper, is not only disingenuous but also blatantly self-serving.

Doctors have been in the news in the past week for two different reasons. The first issue is a carryover from 2018, based on the intention by Parliament to control the consultancy fees for doctors, while the second is a decision by a corporation intending to restrict doctors to prescriptions of generic drugs for its insured patients.

Both instances are a teaching moment on effects that organised professional bodies have on the formation of policy in Kenya.

CONSULTANCY FEES

The attempts by Parliament to control consultancy fees charged by doctors may have support of a majority of the public because of the manner of its framing as a direct quest to make medical services more affordable. This intention attracts support and places the doctors and their union on their defence, with protestations against it interpreted as motivated by their self interest.

And their correct argument is that Parliament’s attempt at price controls for consultancy fees is misguided, their reasoning being that the poor state of public health facilities is the main driver of prices in private medical care hence ought to be the main focus.
And this position has merit because the private and public sector health services are substitutes. Thus most Kenyans only resort to private services because of the better quality or the absence of quality services in the public sector.

Their argument so far is correct, except that the medics expressed an opinion then follow up with the claim that adoption of universal health services model is the solution to the challenges in Kenya’s medical services provision. By this, they are expressing preference for the government to be the main client of the medical profession and pay for health services on behalf of citizens.

The challenge is expressed well but any dispassionate observer can see that the cost of medical services in Kenya is partly driven by the elite model of medical professionals training that the country has maintained, with the effect that the ratio of medical personnel to the population is getting worse by the year.

These doctors are right in opposing price controls for professional services but their reason for it is informed by their self-interest to drive employment of doctors in the public sector. If cost is indeed a problem, there is no assurance that adopting one model of health service provision from the public sector is the solution.

Secondly, it is completely untrue that health services are a ''public good'' that would be best provided by the state. Government may make arrangements for the healthcare to be provided at public cost, but the services are appropriated by individuals at a time.
Therefore, the doctors are right in opposing price controls but some of their reason for that is predictably self interested while others are plain wrong.

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