Fix medical scheme hitch

Teachers, prisons and police officers need a reliable insurance scheme to access quality medical care. This is why they were signed up to a scheme that is jointly managed to enjoy the economies of scale afforded by their large numbers.

But it has not been as smooth as was expected when the medical scheme was mooted. The hitch is an outstanding debt of Sh11 billion, which is hampering access to medicare for them and their dependants.

The only reason people go for a medical insurance is the convenience of access to treatment or consultations at any time. However, as a result of the huge arrears owed to various hospitals through several insurance firms, members of this scheme that is managed by the Medical Administrator Kenya Limited (MAKL) must raise the cash to pay upfront for health services.

MAKL, which oversees the medical scheme for the National Police Service, the Kenya Prisons Service and Teachers Service Commission (TSC), owes hospitals Sh11.6 billion, accrued from April last year. The teachers’ medical scheme accounts from Sh7.6 billion of that debt and the police owe Sh4 billion.

These are huge sums of money that cannot be raised instantly. MAKL has blamed delayed disbursements from the National Treasury. The last disbursements were made last September.

There have been numerous complaints by police and prison officers frustrated over their medical claims being rejected or delayed. The problem appears to stem from the government, which is facing serious financial woes. For instance, it has failed to remit statutory deductions, including pension deductions for civil servants in the six months to last December.

Whatever difficulties there are, the teachers and prison and police officers, who are covered by this scheme, must be enabled to access medicare. There can be no compromise on this.