KMPDU Raises Concerns on the Social Health Insurance Act 2023

The Kenya Medical Practitioners, Pharmacists, and Dentists’ Union (KMPDU) has raised a number of serious concerns about the recently enacted Social Health Insurance Bill 2023. These concerns are rooted in a deep understanding of the needs of Kenyans and the challenges they face in accessing quality healthcare.

According to Davji Atella KMPDU Secretary general,one of the KMPDU’s most pressing concerns is the abolition of comprehensive medical cover for civil servants and county employees. This move would disproportionately impact the poorest and most vulnerable Kenyans, who are already struggling to make ends meet. It would also undermine the morale and productivity of these workers, who are essential to the functioning of the Kenyan economy.

The KMPDU is also concerned about the requirement for informal sector workers to contribute upfront the entire annual amount to the Social Health Insurance Fund. This is a significant financial burden for many Kenyans, who live on low incomes and often have unpredictable earnings. It is also likely to discourage informal sector workers from participating in the scheme, which would undermine its effectiveness.

The KMPDU is further concerned about the transfer of responsibility for managing the Primary Healthcare Fund from the counties to the Social Health Authority. This move undermines devolution and could have negative consequences for service delivery. The counties are best placed to understand the needs of their communities and to provide tailored healthcare services.

In addition to these specific concerns, the KMPDU has also raised broader concerns about the bill’s affordability, dispute resolution mechanisms, and stakeholder engagement. The bill does not adequately address these issues, which could lead to problems in the implementation of the law.

The KMPDU has made a number of recommendations to the government to address these concerns. These recommendations are based on sound evidence and expert opinion, and they are essential for ensuring that the Social Health Insurance Bill 2023 is a fair, affordable, and effective piece of legislation.

The government should heed the KMPDU’s recommendations and work with all stakeholders to ensure that the bill is implemented in a way that benefits all Kenyans. This is essential for ensuring that all Kenyans have access to quality healthcare, regardless of their income or employment status.

Specific examples and data to support the KMPDU’s concerns:

According to a recent survey by the Kenya National Bureau of Statistics, 43% of Kenyans cannot afford to pay for healthcare when they need it.
The informal sector accounts for over 80% of the Kenyan workforce.
The average monthly income of an informal sector worker is less than Ksh. 10,000.

Actionable recommendations:

The government should retain comprehensive medical cover for civil servants and county employees.
The government should allow informal sector workers to contribute to the Social Health Insurance Fund on a monthly basis.
The government should transfer the management of the Primary Healthcare Fund back to the counties.
The government should establish a system of independent dispute resolution mechanisms.
The government should establish a clear and transparent process for stakeholder engagement.

Additional recommendations:

The government should provide financial assistance to informal sector workers to help them afford to contribute to the Social Health Insurance Fund.
The government should establish a system of sliding scale contributions, so that lower-income workers pay less than higher-income workers.
The government should create a dedicated fund to support the provision of healthcare services to vulnerable populations, such as the poor, the elderly, and the disabled.
The government should invest in the development of primary healthcare infrastructure and services in all parts of the country.

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