Insurance companies under fire for resembling a cartel due to high prices dispute with Nairobi Hospital, according to KMPDU.
In a recent development, the Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) has leveled several criticisms against health insurers, accusing them of operating in a 'cartel-like' manner and interfering with patient care.
The union's Secretary General, Davji Atellah, has stated that insurance companies are recommending facilities, doctors, and tests to patients instead of giving them the freedom to choose. This practice, according to KMPDU, is a way for insurers to avoid expenses while draining Social Health Authority (SHA) coffers at the expense of needy Kenyans.
The dispute between Nairobi Hospital and eight insurance companies centers around a revision to the hospital's costs for various services. Last week, these insurance companies pulled their services from Nairobi Hospital following price hikes that they deemed unsustainable. As a result, the hospital has since reverted to its old prices, abandoning the new ones that were set to come into effect on August 12.
KMPDU finds the gradual increase in premiums for various covers and resistance to similar hikes in the costs of medical care insincere. The union has also accused insurance companies of delaying claim remittances, forcing hospitals to turn away patients with insurance covers and demand cash payments instead.
The insurance companies that protested the new rates include Madison Insurance, First Assurance, Minet, Old Mutual, Britam, AAR, CIC, Pacis Insurance, Jubilee Insurance, AAR Healthcare, and Britam Insurance. The Competition Authority and the Insurance Regulatory Authority have been criticized for abdicating their duties to protect patients and service providers, according to KMPDU Secretary General Davji Atellah.
In response to these allegations, the insurance companies have not issued any official statements. However, KMPDU has threatened to release a list of insurance companies to avoid and is planning to advise Kenyans on this matter in the coming days.
This dispute comes at a time when the healthcare sector in Kenya is already strained, with many patients struggling to access affordable and quality healthcare services. The union's criticisms highlight the need for increased transparency and accountability in the health insurance industry to ensure that patients receive the care they need without undue financial burden.
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