Rejecting SHIF and SHA: Why Kenyans Are Being Forced Turn to Private Insurance for Their Healthcare Needs

In a country grappling with economic strain, governmental incompetence, and systemic corruption, the introduction of the Social Health Insurance Fund (SHIF) and Social Health Authority (SHA) has become the newest avenue for betrayal. The government is pressing Kenyans to accept SHIF and SHA, portraying these as the saviors of the crumbling healthcare system. However, upon a closer look, SHIF appears to be nothing more than a poorly disguised mechanism for fleecing the public, offering little to no value in return.

The crux of the issue lies in the dismal benefits offered by SHIF. For example, let us analyze a Kenyan employee who earns Kshs 100,000 per month. Remember , this is an upper class Kenyan. This individual is expected to contribute Kshs 65,000 annually to the SHIF program. The list of services that SHIF offers, from dental care to diabetes treatment, is nothing short of an insult when compared to what private insurance companies such as Jubilee, Britam, and Old Mutual provide for the same or even lower contributions.

For instance, SHIF offers a mere Kshs 2,000 per household for dental care annually. Contrast this with Jubilee, Britam, and Old Mutual, where dental cover reaches Kshs 10,000 and Kshs 7,500, respectively. It is unfathomable how the government expects households to cover even the most basic dental procedures with Kshs 2,000 in a healthcare system where a simple consultation exceeds that amount. The disparity here speaks volumes about the government’s failure to understand or, worse, care about the realities faced by ordinary Kenyans.

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A comparison of maternity services further exposes SHIF’s incompetence. The SHIF system offers Kshs 10,000 for a normal delivery and Kshs 30,000 for a cesarean section. Jubilee and Britam, on the other hand, provide up to Kshs 80,000 for both normal and cesarean deliveries. The difference is staggering. Given the high cost of childbirth in Kenya, particularly in private hospitals, SHIF’s contributions will hardly cover even the most rudimentary services. The outcome is that women and their families will be left paying out of pocket for critical healthcare services, while the government siphons off funds through inflated ICT projects like the absurd Kshs 100 billion SHIF system.

Looking at chronic illness care, the inadequacies of SHIF become even more glaring. For diabetes, SHIF offers only Kshs 4,300 per year, while Britam and Jubilee cover outpatient services up to Kshs 75,000 and Kshs 50,000, respectively. These figures make it abundantly clear that SHIF is not designed to provide comprehensive care for chronic conditions. In fact, it appears that the entire SHIF program is designed to discourage people from seeking necessary medical care by offering such paltry reimbursement rates. Is it a ploy by the government to push Kenyans into private healthcare solutions?

In cases of hypertension and sickle cell anemia, SHIF once again shows its true colors. Offering only Kshs 2,850 per year for hypertension management and Kshs 6,800 for sickle cell anemia, SHIF is grossly insufficient. A single specialist visit or a month’s supply of essential medications can easily exceed these amounts. By contrast, private insurance companies provide coverage for the totality of these conditions, including consultations, medication, and emergency interventions. SHIF’s provisions do not even begin to scratch the surface of what is required to manage these chronic conditions effectively.

At the heart of the SHIF debacle is the government’s allocation of Kshs 100 billion to build the program’s ICT infrastructure, which raises more questions than answers. How can the government justify such an astronomical expenditure on ICT when the healthcare benefits provided by SHIF are so woefully inadequate? This reeks of mismanagement, if not outright corruption. It’s yet another classic example of the Kenyan government prioritizing expensive, opaque projects over the health and well-being of its citizens.

Let us now compare the private sector’s insurance landscape, starting with Jubilee. With an inpatient cover of Kshs 500,000, outpatient cover of Kshs 50,000, and additional benefits such as dental and optical cover worth Kshs 10,000 each, Jubilee provides comprehensive healthcare services at a fraction of what SHIF demands from its contributors. Britam raises the bar even further, offering Kshs 750,000 inpatient cover and Kshs 75,000 outpatient cover, all while charging considerably lower premiums than SHIF. The discrepancies between what private insurers provide and what SHIF offers are impo