Nairobi, Kenya| Moyale Member of Parliament, Professor Guyo Jaldesa, has raised serious concerns over the Social Health Authority’s (SHA) failure to adequately cover medical expenses for patients, despite consistent monthly contributions from Kenyans.
During a heated plenary session in the National Assembly on Tuesday, April 16, Prof. Jaldesa confronted Health Cabinet Secretary Aden Duale, demanding immediate government intervention to address the systemic delays and insufficient payouts by the insurer under the TaifaCare program.
Patients Stranded, Bodies Withheld Over Unpaid Bills
The legislator revealed that numerous patients, including those with life-threatening conditions, are being detained in hospitals due to unpaid bills, while grieving families are unable to retrieve the bodies of deceased loved ones for burial until outstanding balances are cleared.
“Many patients have accumulated bills running into millions of shillings, yet the Social Health Insurance only covers a maximum of Ksh 300,000,” Prof. Guyo lamented.
“These are people who have faithfully paid their monthly contributions, expecting full support in their time of need. Instead, they are left stranded, and families are forced to dig deeper into their pockets despite having insurance coverage.”
Broken Promises: SHA’s Failure to Alleviate Financial Burden
The MP further criticized the government for failing to deliver on its promise that the transition to the new health insurance scheme would eliminate financial burdens on patients and their families.
“We were assured that medical bills would no longer be a burden to society, yet here we are, with patients suffering and families being harassed by hospitals over unpaid dues,” he stated.
Prof. Guyo’s remarks highlight growing frustrations among Kenyans who have embraced the Social Health Authority (SHA), which replaced the National Health Insurance Fund (NHIF) under the government’s Universal Health Coverage (UHC) agenda.
The new system was designed to provide comprehensive and affordable healthcare, but implementation challenges have left many beneficiaries disillusioned.
Calls for Immediate Government Action
The lawmaker pressed CS Duale to outline concrete measures the Ministry of Health will take to resolve the reimbursement delays and ensure that SHIF fulfills its mandate.
“What steps is the government taking to ensure that hospitals are paid promptly and that patients are not held hostage due to unpaid bills?” he demanded.
The concerns come amid reports of widespread dissatisfaction with SHIF’s operations, including claims of bureaucratic inefficiencies, underfunding, and mismanagement.
Some healthcare providers have also complained of delayed reimbursements, forcing them to either detain patients or absorb losses—a situation that threatens to cripple medical services, especially in public hospitals.
Public Outcry and Demand for Accountability
Medical professionals and patient advocacy groups have echoed Prof. Guyo’s concerns, urging the government to streamline SHIF’s operations and enhance transparency in fund disbursement.
“If Kenyans are contributing faithfully, the government must ensure that the money is used appropriately to cover their medical needs,” said Dr. Elizabeth Wala, a healthcare policy analyst. “The current situation undermines public trust in the entire health insurance system.”
As the debate intensifies, pressure is mounting on the Ministry of Health to address these gaps or risk a backlash from millions of contributors who depend on SHIF for their medical security.
CS Duale’s Response Awaited
At the time of reporting, CS Duale had not yet issued a detailed response to the concerns raised.
However, the Ministry is expected to provide a statement outlining corrective measures to restore confidence in the health insurance scheme.
For now, thousands of Kenyan families remain in limbo—caught between exorbitant hospital bills and an insurance system that has yet to fully deliver on its promises.
What Next?
- Will the government expedite SHIF payments to hospitals?
- How will the Ministry of Health prevent future delays?
- What safeguards will be implemented to protect patients from financial exploitation?
These are the pressing questions that demand urgent answers as Kenya’s journey toward Universal Health Coverage faces yet another critical test.
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