When you listen to conversation out there, people are hurting. The cost of goods and services have gone up. People cry at money seems to be scarce and that it doesn’t seem to last through the month. It is not a January phenomenon where one is broke after the festivities but it seems to persist through the year. The cost of healthcare has been high.
Generally the cost of goods have gone up due to many factors like
Taxation: new taxes like VAT caused 16% rise in some medical goods in 2013, KEBS increased the cost of inspection from 10% to 20%.
Increasing price of fuel, cost of electricity tariffs among other things.
This has an effect on the prices of commodities and entrepreneurs need to adjust prices to make their businesses profitable. How can this be rationalized is the crux of the matter.
Its estimated that 1.5 million Kenyan each year are pushed into poverty due to high out of pocket expenses for health care. In order to understand, if a family member doesn’t have health insurance or even NHIf and they break their femur( thigh bone) , they have several options.
They could have surgery to correct the fracture and pay cash for it. The cost varies depending on where they go. Their choice determines how fast they get back on their feet and back to work. If they go to facility that has a long waiting list they could wait unto 3 months to have it fixed. If they have to fundraise to get the money for surgery and there is a delay, then that will delay their recovery process. They then need about 6 weeks off work having physiotherapy and bed rest and then return to work.
They could say I don’t have cash and have Traction done. In this form of treatment, their leg is pulled and kept straight with a weight. They have to remain in this position for at least 3 months . The problem with this that their bones may not heal or heal in a bad position. They are then still not able to get back to work. They could also have other complications like Blood clots ( what we call Deep Vein Thrombosis) which is fatal.
They could also stay home and do nothing. The pain will come down , the bone may not heal or heal in bad position but will not be able to get back to work.
Depending on which option they take, the rehabilitation can be very long. If this person was the breadwinner, the family will suffer with no income since they may not have adequate savings. If the other spouse is able to work, they will have to take time off to come see or take care of them and hence their ability to generate income will be affected.
So the million dollar question is how can this be prevented. Ideally is if they could avoid having to have out of pocket expenses the better unless of course they have money to pay for it. Solutions like NHIF are helpful. If someone has their NHIF up-to date , depending on where they go, they could have the full cost of surgery taken care of. Its a good idea to have your relatives enrolled in NHIF and encourage them to keep it up-to date, It will save you money. One never knows when they may need admission to hospital for a medical condition or even a road traffic accident. This is when it comes in handy. Universal healthcare coverage maybe helpful but it has limitation on where you can go- mainly to the public hospitals and its not spread out to the whole country. It has limitations on the scope of care that can be given depending on the level of the facility and the long waiting time.
For those that can afford another medical insurance apart from NHIF, it can be helpful. Its important to choose carefully the healthcare facility when seeking surgery or admission so that its within your insurance limit and also that your cover can last through the year and its not exhausted quickly. Its always a good idea to seek second opinions for the costs of healthcare / type of treatment being given if you are in doubt so that you consult and have a good cost effective solution.
As a healthcare provider the important question to ask ourselves is how do I price my services and goods so that I don’t push people to straining themselves. You still have to make your ends meet and charge a fair price for your time and still be profitable. You have to make adjustments depending on the countries economic ecosystem but its good to be fair as well. As Healthcare workers we are a position of unbalanced power because people are needing help and are vulnerable. I have think to myself, is my pricing fair? Will this family have to sell their only land to afford my services? If the tables were turned will be able to afford this if I was in their situation?
Sometimes we have to say, what does it mean to love my neighbour?
It would be totally unfair and unjust if my pricing pushes a family into poverty.