President Ruto defends signing UHC laws as Kenyans decry more pay deductions

President William Ruto has justified his signing of four Universal Health Coverage (UHC) Bills into law even as the move results in an increased tax burden for Kenyans.

The four bills include; the Primary Health Care Bill, Facility Improvement Financing Bill, Digital Health Bill and the Social Health Insurance Bill.

This now means that Kenyans employed in the formal sector will make a monthly contribution of 2.75 per cent of their salary capped at a minimum of Ksh.300 and a maximum of Ksh.5,000.

Speaking at the 60th Mashujaa Day celebrations held in Kericho County on Friday, President Ruto defended the move saying that every Kenyan will pay according to their income.

Ruto insisted that by enacting the four bills into law, healthcare access will no longer be determined by financial capacity but rather by the healthcare requirements of every Kenyan.

"Previously, an individual earning Ksh.10,000 had to part with Ksh.500 to NHIF, a hefty 5% of their earnings. On the other hand, those with salaries of Ksh.100,000 or more contributed Ksh.1,700, a mere 1.7% of their income. Astonishingly, even someone with a monthly income of Ksh.1 million, paid the same amount," said President Ruto.

"This bizarre setup meant that low-income earners were effectively subsidizing high-income earners. The Social Health Insurance Fund also signifies a shift to increased use of domestic resources for health financing and a sustainable approach, especially at a time when resources from donors and development partners are dwindling."

President Ruto added that the four new laws will also enable Kenya's healthcare system to shift from concentrating on curative services at the expense of preventive and promotive services.

The head of state emphasized the relatively low adoption of health insurance in Kenya, which he says stands at a mere 26%.

The Head of State added that individuals at the lower end of the economic spectrum are the least covered, with just 5% or less having access to vital health insurance.

Many Kenyans, Ruto went on, similarly incur catastrophic expenditures from out-of-pocket healthcare payments, while many more do not seek care when they fall ill, because they simply cannot afford it.

"It is against this backdrop that the government proposes a paradigm shift in the provision of social health insurance, in the new Social Health Insurance Act, 2023, which provides for the formation of a Social Health Authority which will repeal the current National Health Insurance Fund Act, 1998," said President Ruto.

"I promised a fully, publicly financed primary health care system, an emergency care fund and a health Insurance fund that will cover all Kenyans. This promise is delivered through the enactment of the new Social Health Insurance Act which, among other things, establishes the publicly financed Primary Health Fund."

He added that by enacting the four bills into law, healthcare access will no longer be determined by financial capacity but rather by the healthcare requirements of every Kenyan.

"Previously, an individual earning Ksh.10,000 had to part with Ksh.500 to NHIF, a hefty 5% of their earnings. On the other hand, those with salaries of Ksh.100,000 or more contributed Ksh.1,700, a mere 1.7% of their income. Astonishingly, even someone with a monthly income of Ksh.1 million, paid the same amount," said President Ruto.

"This bizarre setup meant that low-income earners were effectively subsidizing high-income earners.  The Social Health Insurance Fund also signifies a shift to increased use of domestic resources for health financing and a sustainable approach, especially at a time when resources from donors and development partners are dwindling."

President Ruto added that the four new laws will also enable Kenya's healthcare system to shift from concentrating on curative services at the expense of preventive and promotive services.

He further stated that the his government's mission is to build a progressive, responsive and sustainable healthcare system for the benefit of all Kenyans.

"The Facility Improvement Financing Act seeks to ensure a unified approach for health facility financial and management autonomy where public health facilities can retain their funds and have autonomy to operate their facilities based on their priorities. This will improve the availability of resources at the facility to provide adequate and equitable quality health services, increase efficiency and thus improve health outcomes for patients," he said.

While noting that Kenya's healthcare providers have gradually, but not effectively, incorporated technology in their service offerings, Ruto underscored that the Digital Health Act will provide the legal basis for the development of a comprehensive and integrated health information system that will enhance health service delivery. 

"The enactment and implementation of the Act and the digitisation agenda will deliver on the promise to ‘integrate ICT to enhance telemedicine and health management information systems," said Ruto.

"Our mission is clear: To build a healthcare sector that is a shining example to the world, with healthcare workers in the right numbers, who are motivated, well-supported and inspired to deliver their best. Together, we will ensure that every Kenyan has access to quality healthcare services when they need it, regardless of their background or circumstances."