When faced with larger personal expenses, researchers discovered that people forego therapy indiscriminately, regardless of whether it has a high or low benefit.
The Price of Medicine Is Increasing
High medicine prices are the single largest source of patient expenditures in Africa. To safeguard individuals with recurrent or chronic conditions like cancer and diabetes who may require long-term medication, the government should develop policies that control drug pricing based on the clinical benefit of the medication. To ensure that pharmaceuticals are available and inexpensive to the public, the government should negotiate drug costs with manufacturers, importers, and distributors. To prevent families from falling into poverty, a more effective medicine subsidy procedure that regulates pricing, either through government funding support or patient subsidies, should be introduced.
Hospitals are profit-making enterprises.
Private hospitals have raised fees for inpatient and outpatient hospital services considerably faster than the insurance industry can keep up with. For inpatients and outpatients, the majority of private hospitals in Kenya charge more than the NHIF guidelines. The government has the potential to affect private hospital pricing and treatment costs based on a patient's capacity to see specialists or seek more expensive treatments. Although consumers may have fewer options, cost reduction can assist everyone in the community have better access to health care.
Systems Create Waste
Overtreatment, improper pricing, failure in healthcare coordination or delivery, administrative complexity, and fraud and abuse are all examples of waste created by several systems. Excess medical spending is primarily caused by administrative costs. The Kenyan healthcare system is exceedingly complicated, with distinct rules, funding, enrollment dates, and out-of-pocket fees for employer-based insurance, private insurance, and government insurance, all of which cover the National Health Insurance Fund (NHIF) in its various forms.
For providers, employing health insurance entails complying with a plethora of rules including hospital acceptance of the insurance coverage, asking clearance prior to service delivery, and billing. These operations account for the majority of administrative expenditures, resulting in higher premiums for the insured. Individual healthcare spending can be reduced with better consumer education on health awareness and preventative health.
The cost varies a lot.
In Kenya, the system's complexity, the lack of defined prices for medical services and providers (private health providers are allowed to charge whatever the market will bear), and the government's negligence in enforcing laws and price limits have led to greater patient abuse. Treatment and drug prices should be recognized by all health stakeholders, including commercial and public sector politicians, and diverse measures to decreasing treatment costs should be considered. Transparency in healthcare pricing for patients can aid the sector's development of a more logical and equitable economic structure. Price transparency offers policymakers and analysts useful data from large data sets, allowing them to better understand the current system and evaluate policy changes for future health.
Over-reliance on imported health products
Kenya produces an extremely limited number of medical items. The majority of medical supplies and consumables are imported, as are over 90% of important medications, laboratory and radiology instruments, diagnostic kits, and the majority of medical supplies and consumables. Due to logistical constraints, the importation of medical items has resulted in higher rates for services and products, as well as a delay in service delivery.