The government is not part of the solution, the government is the problem. I fully support the government in trying to ensure universal health coverage for its citizens, but I disapprove the manner in which the government is approaching the matter. Access to health is a constitutional protected right; this is enshrined in our constitution under article 43. (1) (a) but this rights should not be enforced to the detriment of others people. In the execution of the enumerated rights of citizens, the state is obligated to balance the employee’s interests upon matters of financial and economic public concern against the state’s entrenched interest in the provision of the ever elusive “efficient public service”. By any stretch of imagination, public service in Kenya can only be efficient in our dreams.
The monster, The National Hospital Insurance Fund (NHIF) in cahoots with the minister for medical services have decried that the monthly contributions payable by Kenyans has to be reviewed upwards. This was done without any regard to the views of those who are to chuck out the money. Revolutions the world over have been started on the premise of taxation without representation. And by revising the monthly contributions upwards without seeking the opinion and input of the Kenyan worker, the government and NHIF may have just list the tinder for a revolution against them. The minster in question is one of those people who do not trust the medical services offered in Kenya but has to travel abroad for his health needs.
The government and NHIF cannot operate in isolation while making laws while public participation is a basic tenet of our jurisprudence. NHIF has not been forthright and forthcoming in respect of provision of the services which it is legally mandated to do, but it has been efficient in levying monthly contributions all the same without much a do. Now is the time to question where and what the monies remitted goes and does. This will ultimately increase accountability on the part of NHIF. We cannot continue sinking money in this black whole without question the rationale for doing so.
In terms of content, the Kenyan constitution ranks among the best in the world, if it ain’t the pinnacle. It elucidates patently clear under article 43 (3) that The State shall provide appropriate social security to persons who are unable to support themselves and their dependants. Whether this has been done in a single case is not the business of the government to know, it seems we have laws to be like the rest of the people, not to implement them. The government and NHIF need to carry out their duties with the amount we are giving them before they can come knocking for more money.
Given a choice, I would stop remitting even the monthly contribution I have been making because it does not help any one, but is used in fueling fuel guzzlers of NHIF fat cats. I hope that the Central Organisation of Trade Unions (COTU) will appeal against the ruling issued by Hon. Justice Mohammed Warsame granting the NHIF to start collecting levying the increased rates and prevail. The court’s ruling in my opinion departed from the economic repercussion of the NHIF actions and failed to advance the right to access to health services and ended up harming the important interest at stake.