The importance of an effective and affordable medical insurance regime in improving health and socio-economic outcomes cannot be gainsaid.
Insurance enhances access to care and is usually a gateway to quality health provision that guarantees improved productivity within the workforce. This is why the recent decision by the government to withdraw police medical cover from the National Hospital Insurance Fund (NHIF) has triggered concerns.
The decision, made at a time NHIF membership is growing, with many State entities especially counties signing into comprehensive and super cover medical deals with the insurer, has shaken the insurance market.
The Sh9 billion police medical insurance cover, awarded to a consortium led by the CIC after the NHIF allegedly quoted higher in their bid to retain the deal, should be utilised to better access to medical services for the National Police Service employees and their colleagues in the Kenya Prison Service.Officers have previously gone through painful tribulations at the hand of private insurers, which made the previous government to embrace NHIF in a strategic deal that was meant to help weed out middleman ship and rampant corruption in the insurance sector.
A few years ago, the government ordered the arrest of some senior managers of an insurance company following complaints of unpaid claims by families of several deceased police officers. The then State Department of Interior and National Coordination intervened. Beneficiaries say some claims are yet to be settled. Police, being a sensitive department, with high risks due to the nature of their operations, deserve a properly managed medical cover. In my view, the government should resist the allure of attractive packages that end up being watered down.
The insurance regulatory authority should monitor and evaluate some of the offers and their actual implementation to save the public from spending too much money on what does not benefit government officials fully.
It is important that the new insurance deal for the police be looked at and sections that appear discriminatory removed. At the end of it all, the public and indeed the police should get value for money. Junior police officers bear risks that members of the police force come through every day.The new deal by CIC and others has separated the management of the medical scheme. Junior officers from Job Groups A-L have been put under the management of the Medical Administration Kenya Limited while those from M to T are under the Minet Insurance Brokers.
The terms already announced by the Medical Administration Kenya Limited appear to be reducing the benefit of the lower cadre officers, yet the amount insured is higher than what was offered in the previous years.
NHIF should improve on its services wholesome.
NHIF should stick to deals its signs with clients. For example when an optical cover is Sh40,000, why put capitation claims to under 50 per cent of the amount? This has also been the case when it comes to dental care and other critical ailments.
The publicly funded entity should provide world class insurance services.
Due care should be taken to ensure both the insured and the taxpayer gets value for money. Middlemen and gold-diggers should have no place in such crucial processes. Efficiency and affordability should be at the core of decisions on this crucial aspect.
