Medical Services Principal Secretary Harry Kimtai has explained why the government transitioned from the National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF), addressing concerns regarding its efficacy.
Over recent weeks, SHIF has faced criticism for allegedly excluding numerous patients, effectively limiting their healthcare access.
PS Kimtai explained that this change aims to eliminate system flaws that enabled corruption while ensuring equal health service payments for all Kenyans. Under NHIF, members paid between Ksh.500 and Ksh.1,700, but SHIF has adopted a new model where everyone contributes 2.75% of their gross income without a cap. This shift emphasizes equal benefits, though individuals seeking additional benefits may opt for private insurance.
“There’s no cap—it’s SHIF, where everyone contributes, and the benefits packages are uniform,” Kimtai stated on KTN News, adding that higher contributions do not translate to higher benefits.
He also addressed concerns that SHIF implementation was hurried, clarifying that the State extensively tested the system before its October 1 launch.
Kimtai attributed reports of unauthorized dependents on members' accounts to data integration issues between SHIF and the National Education Management Information System (NEMIS). Initially intended to simplify dependency registration, the government now requires parents to add their dependents manually.
Critics argue that SHIF’s benefits fall short compared to private insurance plans. For instance, SHIF offers Ksh.10,000 for standard delivery and Ksh.30,000 for cesarean sections, with a daily inpatient cover of Ksh.2,240 for up to 180 days per household annually.
Additionally, dental and optical coverage under SHIF is limited, with Ksh.2,000 for dental and Ksh.950 for eyeglasses annually—significantly less than private insurers offer.
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