a Maternity Wing at Ruben Centre
Esther Passaris
Francis Nderitu
Mukuru Kwa Ruben

Unpaid bills a sign of low health insurance uptake

A video of a visibly flustered Nairobi Women Representative Esther Passaris engaged in a heated exchange at a local hospital has gone viral. The arguments gleaned from discussions online appear to be about an alleged “detention” of a patient over an unpaid bill. The unfortunate thing about similar arguments is that they are from the patient’s and society’s viewpoints. Little regard is put on hospital administrators’ challenges.This occurrence in itself is just a symptom of a malignant and chronic illness that needs all our efforts to tackle — the lack of medical insurance and a dysfunctional health system.Until we address these, such scenarios will repeat.In this particular incident and others including somewhere bodies have been detained by morgues due to unpaid bills, I beg to wear a hospital administrator’s hat and argue from their perspective.Healthcare is expensive, quality medical services even more so.To run any hospital not supported by State funds is challenging. One has to balance between offering a vital service and staying afloat. Rent, salaries and licences, among others, all have to be paid from collected patient fees.

Private hospitals do not own health personnel, they hire and pay them from patient service charges. The infrastructure they have also has to be maintained, again from the same source.Where services are rendered and patients do not pay, hospitals have to still pay their staff. Like clockwork, at the end of the month, salaries, taxes, rent, suppliers invoices are due regardless of whether patients paid or not.This fact is unfortunately ignored by the public and politicians’ courts. To cure the problem, the honourable member could lobby and ensure the legislated emergency fund is full, so far it is empty, legislate to have hospitals’ waivers knocked off from this kitty.Ms Pasaris could also lobby to have hospitals offset due taxes from waived patients’ fees, legislate to allow hospitals to delay salaries until patients pay up and hopefully convince doctors to accept this ungrudgingly.Better still, a final law to exempt waiving hospitals from licensing fees and utility bills could also be fair.But because today happens to be World Universal Health Cover Day, mheshimiwa could legislate to ensure everyone has health insurance.Hospitals and doctors would then focus on quality service delivery.

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