NHIF in trouble over rich Kenyans treated abroad

NHIF acting CEO Nicodemus Odongo (centre) when he appeared before a House committee on October 23, 2019. PHOTO | JEFF ANGOTE | NATION MEDIA GROUP

What you need to know:

  • Acting NHIF Chief Executive Officer Nicodemus Odongo told MPs the process of clearing people to go abroad for specialised treatment is not biased, adding that it’s done by the ministry.
  • The legislators directed NHIF to provide the list of the private hospitals that have benefited from the kitty and the names of individuals who were facilitated by the insurance fund to go for treatment abroad.

MPs have raised concern over the high number of rich Kenyans going abroad to seek treatment under the National Hospital Insurance Fund (NHIF) at the expense of poor citizens.

Documents of financial statements presented before the National Assembly Health Committee Wednesday revealed that NHIF paid out Sh17 billion for specialised packages for patients who sought treatment abroad in the 2018/2019 financial year.

PRIVATE HOSPITALS

The MPs demanded an explanation from NHIF on why it paid more money to private hospitals.

The report on the financial reimbursement to hospitals indicate that private hospitals gobbled up Sh22 billion compared to government hospitals, which received only Sh7 billion. Mission hospitals collected Sh8 billion from NHIF.

The legislators directed NHIF to provide the list of the private hospitals that have benefited from the kitty and the names of individuals who were facilitated by the insurance fund to go for treatment abroad.

MPs David Ochieng (Ugenya), Eseli Simuyu (Tongaren), Zachary Thuku (Kinangop) and Swarup Mishra (Kesses) said the poor have been contributing at NHIF to facilitate the rich to go abroad for specialised treatment.

“How do you determine who should be flown out for specialised treatment, or it’s based on who you know and the connection one has at NHIF? Asked Mr Mishra.

“You are not qualified doctors, so how do you know the condition one if suffering from, and who needs to be flown out of the country?” He added.

“The poor are subsidising treatment for the rich and you cannot stand in the gap for them,” added Mr Simiyu.

But acting NHIF Chief Executive Officer Nicodemus Odongo told MPs the process of clearing people to go abroad for specialised treatment is not biased, adding that it’s done by the ministry.

“One cannot just come to NHIF and say they ate going abroad for treatment. The ministry must give a greenlight” Mr Odongo said.

Mr Odongo added that NHIF only pays a maximum of Sh500, 000 for individuals seeking treatment abroad.

He further told the committee chaired by Murang’a Woman Rep Sabina Chege that most of their members prefer to go to private hospitals but NHIF does not cater for the entire bill

“Private hospitals received more money because most members go to these facilities. However, they pay for themselves the amount above what we pay.”

Mr Odongo further noted that the fund pays 100 percent of patients’ bills in public hospitals to encourage their members to go to such facilities.