Are medical bills driving people into poverty in Kenya?

  • In Kenya, one in four shillings spent on health is from personal funds
  • Out-of-pocket spending prevents many from seeking medical care in Kenya
  • Only one in five Kenyans have some form of medical insurance meaning close to 40 million Kenyans are exposed

Not a day goes by in Kenya without an appeal for funds as people seek medical treatment for their loved ones.

In an economy and health system that has proven to be discriminatory against the poor, falling sick is dreaded due to the uncertainty of receiving medical assistance and the medical bills people are slapped with, usually.

In Kenya, one in four shillings spent on health is from personal funds. This figure is probably higher.

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Zero-sum equation

In a country that is largely without medical cover for the masses, out-of-pocket spending prevents many from seeking medical care since it becomes a matter of stealing from John to pay Jane in an almost zero-sum equation.

According to the Kenya Integrated Household Budget Survey 2015/2016, only one in five Kenyans has some form of medical insurance. This means that the rest, close to 40 million Kenyans are exposed to the poverty brought about by seeking healthcare services.

A sample medical Bill. Only one in five Kenyans have some form of medical insurance. [Photo/elsetge]
The joint survey conducted by Financial Sector Deepening Kenya, the Kenya National Bureau of Statistics and the Central Bank of Kenya found out that as many as a third of the adults polled opted to not seek medical attention when sick due to the high cost of drugs and the low health insurance coverage in Kenya.

Cancer has become an epidemic in Kenya and more often than not, those hit by the scourge which manifests itself in many forms are subjected to a lifelong dependence on treatment that is unaffordable. The sad reality is that many die after having exhausted their resources and never getting the healing they seek.

Many families have resorted to selling property, organising fundraising events and other means to raise funds for treatment. For those with the means, they can get treatment from any part of the world with India being the favourite for many seeking cancer treatments.

Getting treatment in Kenya’s medical institutions is akin to signing up for an expensive loan that may not be easy to service.

For instance, people who have opted to go to India say that the costs in the Asian nation are twice or thrice cheaper for the medical part. They thus opt to raise funds for the airfare and get the treatment outside Kenya.

Getting treatment in Kenya is financially draining since the National Health Insurance Fund is largely unreliable. The national scheme is the biggest insurer covering more than 90 per cent of the about eight million Kenyans with health insurance.

This means that no matter what kind of illness, the patient has to dig into their pockets despite the cover.

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According to The 2019 FinAccess Survey, more than half of Kenyans struck by illness rely on family and friends in their social networks to help with emergencies.

For those who can, they sell assets while others borrow from financial institutions like banks or microfinance institutions or saccos.

To meet the costs of treatment, others will start doing extra jobs while yet others will turn to mobile money and savings groups for the finances.

Many retirees have to depend on their children for medical cover. [Photo/Pexels]
Global poverty driven by medical needs

According to the World Health Organization, 100 million people slide into poverty each year due to medical care expenses.

WHO adds that medical care needs force another 150 million people to spend nearly half their incomes on the same.

Ironically, those from the world’s poorest countries contribute way more to health care than those in wealthy nations.

For example, in Germany where the average GDP per capita is US$32 860, only 10 per cent of all medical expenses nationwide are borne by households. Interestingly, everyone has social health protection.

In contrast, the Democratic Republic of Congo’s GDP per capita is only US$120 but households spend about 70 per cent of their money on medical care.

In the US, eight million Americans were forced into poverty in 2018 due to healthcare expenses.

According to the Census Bureau, medical expenses remain the largest contributor to the increasing poverty of individuals.

While medical cover is important, the bottom line is that people without insurance are at the highest risk of falling prey to poverty.

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