MPs urge termination of Minet teachers’ medical scheme
The plight of teachers in need of medical services is expected to continue due to the ineffectiveness and ‘outrageous’ insurance coverage costs set by the Social Health Authority (SHA), as revealed by the Teachers Service Commission (TSC) yesterday.
Concurrently, Parliament is now requesting that TSC end its agreement with Minet Insurance brokers and a group of underwriters for the delivery of medical coverage for teachers, describing the arrangement as an “undefined structure. ”
A parliamentary group was informed yesterday that TSC chose to renew the contract for a comprehensive medical coverage plan for teachers with Minet Kenya Insurance brokers Ltd, which is currently facing operational issues that have obstructed teachers’ access to healthcare, owing to SHA’s lack of systems to cater to the vast number of teachers.
TSC Chief Executive Officer Nancy Macharia reported to the National Assembly Education Committee that the Commission had approached SHA for the establishment of a medical scheme for teachers, but the authority admitted to possessing inadequate structures to carry out the task.
Macharia further disclosed that SHA was requesting Sh37 billion to enroll teachers in its medical scheme, a significant increase from the current allocation of Sh20 billion designated for the scheme.
“Last year, we held a meeting with SHA but they stated that they lacked the necessary structures to implement the scheme. They were also requesting Sh37 billion to enroll the teachers with SHA but even then they claimed they were not prepared to accept the teachers this year,” stated Macharia.
She clarified that TSC had signed a three-year agreement with Minet in 2015 and had put out tenders for it twice thus far, but at one point aimed to cancel it due to teachers’ complaints regarding delayed insurance payment approvals, burdensome pre-authorization requirements at medical facilities, and teachers being denied treatment at hospitals.
Consequently, she mentioned that the Commission had sought to place teachers within a public medical scheme.
“We have only tendered this scheme under Minet Insurance two times. Previously, we also tried to engage the now-defunct NHIF but the amount they quoted was too high for funding. I later contacted the Treasury to request an increase in the funds we receive so we could acquire the coverage but there were no funds available, which is how we ended up with Minet Insurance and the consortium,” added Macharia.
The CEO’s remarks addressed the concerns raised by the Education Committee, which had highlighted inefficiencies in the medical scheme accessible to teachers and inquired about any plans to transfer teachers to SHA.
“There are concerns regarding the inefficiencies of the medical scheme that teachers have reported. I am aware of a case involving a teacher who was held in isolation at the Upperhill Hospital for three months on the grounds that the facility was not authorized to provide the medical services she had received,” stated committee chair Julius Melly.
“We had to step in to ensure her release,” he stated.
Kibra MP Peter Orero revealed that instructors had lodged complaints indicating that whenever they attended the consortium-sanctioned hospitals, they were not provided with medication and were required to purchase the drugs independently.
Orero further mentioned that many teachers were being denied service at health facilities and informed that they had not been registered in the medical system.
Macharia clarified that the government’s failure to provide timely financial disbursement had exacerbated the situation.
“We are experiencing initial challenges with Minet, but if our educators are to receive premium services, they must be fully insured. However, we lack the necessary resources to achieve that,” she stated.
This, nonetheless, only attracted further examination of the medical scheme from the members.
“We understand that Minet is an insurance brokerage firm that collaborates with eight other insurance companies within a consortium. Considering all these underwriters and the delays in approvals, who is responsible for the approvals? ” asked committee vice chair Eve Obara.
Attempts by the Commission’s attorney to clarify that the contract with the consortium would expire in November this year and that a determination regarding teachers being incorporated into the “enhanced” SHA system would be made at that time, were met with criticism and calls to end the contract before that date.
“What type of insurance coverage is this? It is a mixed breed. It lacks structure. You are obtaining an insurer, a primary consortium, functioning as an administrator and a capitator. Quite an odd form of insurance. You must disengage from this arrangement,” Melly stated.
“We cannot continue conducting business in the same manner and anticipate different outcomes. The consortium is a nebulous organization that does not provide services,” said Luanda MP Dick Maungu.
Baringo North MP Joseph Makilap suggested grouping teachers together so that they can gain access to premium healthcare.
“As TSC concludes this contract in the next six months, educators will suffer. I recommend that we partition them into groups and secure them good insurance coverage, or we bundle them into SHA and hope for the best,” Makilap commented.
The Committee subsequently called upon the leadership of Minet Insurance Medical Association of Kenya, Blis Hospitals, and all consortium members to appear before it.