The National Health Insurance Fund (NHIF) Act, provides that any person who is ordinarily resident in Kenya and has attained the age of 18 years; and whose total income, whether derived from salaried or self-employment, in the immediately preceding month, was not less than the amount prescribed shall be liable as a contributor to the fund.
Contributing funds to NHIF is a precautionary measure in the event of health-related emergencies. With an NHIF card, Kenyans can access basic medical services from NHIF accredited institutions. The NHIF Board pays from the Fund, benefits to declared hospitals for expenses incurred at those hospitals by any contributor, his named spouse, child or other named dependant.
The Act also provides that all money in the Fund which is not immediately required for covering medical bills could be invested in trust funds of a reputable banks or be used in the procurement and acquisition of essential medical equipment for provision to hospitals as advised by the board.
But the public has always raised numerous complaints against the fund, over its mismanagement questioning the capacity of NHIF to manage the medical scheme. Civil servants cannot access treatment and care for chronic illnesses using the scheme, some have been denied access to life-saving services such as ambulance evacuation while some patients have had to buy medical supplies provided under the scheme. MPs even pointed a finger at the National Hospital Insurance Fund (NHIF) for spending billions to cater for medical expenses of the well-off patients in high-end private hospitals when the poor are left at the mercy of Harambee.
In an experts taskforce report on restructuring of NHIF presented to Ministry of Health CS Sicily Kariuki today, the panel recommended that NHIF should be turned to a social health insurance body to ensure essential health services are available to all Kenyans. Social insurance is a form of compensation provided and controlled by a government for elderly, disable, or unemployed people that. This will ensure much better health coverage.