KENYA :MPs back State control of hospital, doctors charges

September 2021 Businessdaily ; MPs have backed changes to the law that will grant the State powers to control medical bills and doctors’ fees, a move aimed at stemming the surge in hospital expenses.

The National Assembly Committee on Health approved the proposed amendments to the Health Act 2017 that will see medical charges determined and capped by an 11-member council that includes the Principal Secretary for Health and the Attorney-General.

“The committee having considered the Health Amendment Bill, National Assembly Bill No 14 of 2021 recommends that the House approve the Bill with amendments as proposed,” the committee chaired by Murang’a Woman Rep Sabina Chege said.

The Bill seeks to amend Section 31 of the Health Act of 2017 to have the Kenya Health Human Resource Advisory Council (KHHRAC) determine prices for medical services and doctor’s consultation fees.

KHHRAC currently handles the human resource function in the public healthcare system, including posting and transfers of doctors, nurses, and other medical specialists.

The parliamentary committee also agreed to amendments that will make it a crime for private and public health facilities to demand down payment as a condition to providing emergency medical services.

The Bill had proposed to make it a crime for public hospitals to demand down payment before providing emergency services but the Ministry of Health petitioned the committee to include private hospitals.

If endorsed by the House, the law will see hospital charges join fuel in a list of essential services controlled by the government in the push to make basic items affordable.

The cost of medical services especially in private hospitals has surged in recent years, putting treatment out of reach of households who lack insurance cover and whose purchasing power has been eroded by the coronavirus economic fall-out.

The committee’s report awaits Parliamentary approval before it can be presented to the President for assent.

The Kenya National Bureau of Statistics’ Integrated Households Budget Survey report released in 2019 shows that 81 percent of Kenyans have no insurance or pay for the medical bills out of pocket, highlighting the vulnerability of the households.

It means that only 19 percent of the households have some form of medical insurance. The report shows 17.8 percent of households primarily depend on the National Hospital Insurance Fund (NHIF) while the remaining 1.16 percent are under private or arranged cover.

Health inflation hit an all-time high of 4.56 percent in June, signalling higher hospital bills at a time when Kenyans were struggling with job losses and lower incomes.

A section of insurers, however, accused medical practitioners of driving up medical inflation through many charges for services that patients do not need.

Some doctors take patients through procedures such as various laboratory tests for which they charge the insurers exorbitantly, raising the overall cost of medical care.

The rise in the cost of medical services is also piling pressure on insurance premiums.

Besides the possibility of locking out low-income earners from accessing quality medical care, the increase in medical charges is expected to take a huge chunk of expenditure from the upper and middle-class families, eroding their purchasing power on discretionary expenses.

Private hospitals have previously opposed the bid to have the government control hospital charges, arguing it risks lowering the quality of medical care.

The push to tame hospital bills comes at a time the State has sponsored a Bill to control commercial and residential rents in the quest to protect tenants from sharp building lease costs.

The government-backed Landlord and Tenant Bill of 2021 proposes that rent increase should not exceed the annual average inflation rate for the preceding year.

Kenya has preferred to let market forces control the cost of basic commodities despite the existence of a law that provides for the capping of prices.

A law introduced in 2011 allowed the return to price controls of essential commodities after the practice was abandoned in the 1990s in favour of economic liberalisation.

The law allows the Treasury Cabinet Secretary to declare certain goods essential commodities and determine their maximum prices through an order in the Kenya Gazette.

This notice has only been issued once in 2017 when the State capped the price of a two-kilo packet of maize flour at Sh90 after the cost of the commodity more than doubled to breach Sh150.

In November 2019, Kenya removed a cap on commercial lending rates imposed in 2016, which had been blamed for curbing private sector lending growth.

But Kenya has been setting price caps on fuel monthly since 2010 and has since April kept diesel and kerosene prices unchanged despite the sharp recovery in the global prices of crude.

The move to determine and cap medical bills comes weeks after the State lost its bid for compulsory membership to the NHIF for all Kenyans aged 18 and above.

The parliamentary health committee rejected the proposal and said that the national and county governments would instead pay contributions for the 5.1 poor households across the 47 counties.

Compulsory membership to the NHIF would have seen every adult pay Sh500 per month, boosting the scheme’s cash flows in the race to provide affordable healthcare to all Kenyans.

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