Only 20% of Kenyans have some form of health insurance – Report

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Only 20 percent of Kenyans have some form of health insurance even as the country is geared towards universal health coverage (UHC).

It is according to the project Kenya Comprehensive medical report that shows the healthcare sector faces low levels of public health insurer penetration and low levels of overall UHC.

The report proposes changes to the current regulatory framework for health insurance with the aim of increasing penetration and enabling the private sector to contribute to the achievement of the government’s goal of universal health coverage.

The draft report which was drawn up by the team of actuaries and consultants i3 which was hired by the National Treasury proposes to integrate community health into the regulation of Insurance regulator (IRA) as well as licensing and regulation Health maintenance organizations as a new license category at the IRA.

In addition, the report proposes that all policyholders have access to the same policy options and be included in the same risk pool, while a prescribed minimum benefit package (PMB) for all health insurers should be implemented. .

“There should be a provision for regular review and amendment of the PMB package to accommodate changes in affordability and the overall disease burden,” the proposal document says.

In addition, the document proposes that the IRA have the power to apply corrective measures to market participants who set unreasonably low premiums.

It has also been proposed that insurers file marketing materials with the IRA for approval at the same time as benefit design approval. The material should be simple for consumers to understand and signed by a senior official or person with appropriate authority to whom responsibility has been delegated.

Other proposals in the document include the establishment of an independent accreditation body to carry out the accreditation process for all healthcare providers in the sector with the engagement of all other provider bodies in the sector. sector, such as Kenya Council of Physicians and Dentists, council of clinicians, council of nurses Kenya, council of pharmacy and poisons and ministry of health.


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