KMPDU slams 'cartel-like' insurers after Nairobi Hospital prices dispute

The Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) is accusing health insurers of running a ‘cartel-like’ operation that has denied patients access to desired medical care in addition to frustrating doctors.

The accusation comes amid an ongoing dispute between Nairobi Hospital and eight insurance companies, which object to a revision to the facility’s costs for various services.

According to KMPDU, the big companies have suspended rules of fair play and were using tactics such as blackmail to gain profits with less regard for the patients they cover.

“As a union, we have been taken aback by the recent developments where insurance companies have come together to fleece and interfere with the management of patients by our doctors. Our members have complained that third parties (read insurance companies) are getting between them and their patients, thus interfering with patient care,” said KMPDU Secretary General Davji Atellah.

The doctors have questioned why the insurers have been recommending facilities, doctors and tests to patients instead of giving them the freedom to choose.

At the same time, some of the companies face accusations of delays in remitting claims, forcing some hospitals to turn away patients with their covers, with the alternative of demanding cash payments instead.

KMPDU has further called out a practice where patients are asked to settle hospital bills with the Social Health Authority (SHA) cover before their private insurance is utilised. This, the doctors argue, was a way of cushioning insurers from incurring expenses while draining SHA coffers at the expense of needy Kenyans.

However, it is the gradual increase in premiums for various covers and resistance to similar hikes in the costs of medical care that KMPDU found insincere.

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“As this happens, the Competition Authority and the Insurance Regulatory Authority have abdicated their duties to protect the patients and the service providers,” Atellah remarked. 

“In the coming days, KMPDU will release a list of shame and advise Kenyans on which companies to avoid. We will not sit back and watch private interests frustrate the quality of healthcare and the much-needed universal access.”

Last week, insurance companies pulled their services from the Nairobi Hospital following price hikes which they deemed to be unsustainable. Some of the insurance companies that had protested the new rates include Madison Insurance, First Assurance, Minet, Old Mutual, Britam, AAR, CIC, and Pacis Insurance.

The hospital has since adopted its old prices, abandoning the new ones, which were set to come into effect on August 12.