SHIF faces imminent collapse as funding crisis deepens

The Social Health Insurance Fund (SHIF) is at risk of collapse in the next 12 months if the current model is maintained.

According to the Kenya Association of Private Hospitals, the current funding model is unsustainable, as only 22% of the 20 million Kenyans registered with the fund are making contributions.

Speaking before the National Assembly Committee on Health, the Chairperson of private hospitals in Kenya, Erick Musau, told the legislators that only a small number of registered Kenyans are paying their premiums, making the fund unsustainable.

Musau added that only salaried Kenyans are paying their premiums, with just 7% of non-salaried citizens contributing, and only when they need medication.

“We do not feel that sufficient safeguards have been put up to ensure that people continuously contribute to this kitty and not just when they need services, and if this trend goes on like this, we do not see this fund surviving beyond 12 months,” he said.

On his part, Kenya Healthcare Federation Chairperson Kanyenje Gakombe stated that a mechanism needs to be in place to ensure non-salaried Kenyans pay their premiums for the fund to work.

While defending private and faith-based hospitals for suspending admissions of patients using the fund, Gakombe said most hospitals can no longer bear the burden.

“We want medical insurance to succeed, we have worked to make sure that SHA succeeds, our stopping or services is an act of desperation, our willingness to give Kenyans services should not be doubted, but our ability to do so is the problem because we need funding,” he said.

“We must put a law to ensure that the non-salaried also pay their premiums, we need a way to collect money for medical, leaving it to individuals to decide whether they will pay or not, will not work.”

Gakombe’s sentiments were echoed by Dr Brian Lishenga of the Rural and Urban Private Hospitals Association of Kenya (RUPHA), who told the MPs that the most affected facilities are level 2, 3, and 4 hospitals, which rely on Primary Health Care that is supposed to be funded by the government.

Further, Lishenga told MPs that the fund requires Ksh.8 billion in the next 12 months, but only Ksh.4 billion has been set aside this financial year.

“Anything that SHIF pays is paying level 4, 5 and 6 and that is only 9% of health facilities in Kenya, 91% of providers are not being paid, the last time they were paid was November and that is where the majority of Kenyans are, and they are getting negative experiences,” he said.