Social health insurance in Kenya - learning from experiences of other countries to enable success

Abstract

Social Health Insurance (SHI) refers to an insurance scheme in which the policyholder is compelled or encouraged to take up health insurance through the intervention of a third party usually the employer. The movement towards SHI has been due to the desire to expand national insurance coverage and to reduce financial pressure on public budgets. Empirical evidence indicates that SHI results in a shift of the burden of delivering and financing healthcare from the public sector to the private sector and reduces out-of-pocket expenditure for healthcare services. In 2004, the National Social Health Insurance Fund (NSHIF) Bill was passed before Parliament but was rejected by the President. The NSHIF Bill was a policy document, which if accepted, would have seen the implementation of an SHI program in Kenya after a transition period. The reasons cited for the rejection are financial constraints and political issues of the Bill. This Paper seeks to further investigate these reasons and determine optimal solutions to them.