KMPDU trains guns on medical insurance ‘cartels,’ threatens to release list of shame

The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has accused major insurance companies of undermining quality healthcare through what it terms as blatant interference in patient management, warning that it will soon publish a “list of shame” advising Kenyans which insurance firms to avoid.

KMPDU Secretary General Dr. Davji Atellah, speaking during a press address on Tuesday, decried what he called the “medical insurance paradox” and a growing cartel-like culture within the health insurance sector that puts private profits above patient care.

“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,” he said.

He added that doctors have complained about third parties “getting between them and their patients, thus interfering with patient care.”

The union said insurers are now choosing which hospitals patients should visit — citing the recent happenings at Nairobi Hospital — which doctor they should see, and which tests and medication they should receive.

Dr. Atellah further accused the companies of “not settling claims on time,” forcing hospitals and doctors to insist on cash payments.

He castigated the firms for allegedly insisting that the Social Health Authority (SHA) “pays for the bills first before they come in,” which he warned was draining public funds “instead of them helping to preserve it for the poor.”

He added that even as they cite the tough economic climate to justify hiking premiums, “they do not want the service providers to also increase their charges.”

“This unbecoming, cartel-like behavior is being perpetuated by the big insurance companies, who blackmail the service providers into submission,” he stated.

According to the KMPDU boss, regulatory agencies such as the Competition Authority of Kenya and the Insurance Regulatory Authority have “abdicated their duties to protect the patients and the service providers.”

The union now plans to release a list of the implicated firms, saying it “will not sit back and watch private interests frustrate the quality of healthcare and the much-needed universal access.”

“Insurance companies are becoming an impediment to quality healthcare access. We call upon the regulators to step up and do their job,” he noted.

Dr. Atellah also seized the opportunity to spotlight the ongoing Kiambu County doctors’ strike, cautioning that it must not fade from the public conscience.

He said the county administration had remained “adamant” even after 85 days of industrial action.

“Our doctors remain strong and we continue with the same resolve until all our issues are resolved,” he said.