The Teachers Service Commission (TSC) has severally been accused of colluding with teacher aligned unions like Kenya Union of Post Primary Education Teachers (KUPPET), Kenya Women Teacher’s Association (KEWOTA), and Kenya National Union of Teachers (KNUT) to orchestrate the oppression of teacher with medical insurance schemes which doesn’t offer much to the teachers.
In recent times, the biggest complaint against Teacher Service Commission (TSC) has been that its colluding with insurance services provider Minet in the multi-billion medical insurance to exploit teachers while offering mediocre or non-existent services.
The tender was awarded in 2019, despite a warning by this blog that the insurance provider was incapacitated, since it lacks proper hospital network to deliver services effectively to teachers across the country.
First, this writer understands that the teachers pay between Ksh954 and Ksh3,000 every month each, but the services offered in health facilities are wanting.
Teachers in job group B5 (P1 teachers) have their monthly deductions at Ksh954 per teacher, while those in job group H contribute Ksh1,200 every month.
In job group K, the contribution per month per teacher range from Ksh1860 to Ksh1,897, while those in job group L contribute Ksh2,246.
Job group M teachers monthly deduction stands at Ksh2,688 while those in job group N contribute Ksh3,044.
Well, if you are wondering how much this amounts to, here is the math, according to the number of teachers on the TSC roll.
P1 teachers contribute at least Ksh90 million every month, Group H Ksh33 million, Group K Ksh55 million while Group L contributes Ksh74 million. Teachers in Job Group M contribute Ksh64 million while Group N contribute Ksh21 million every month. In estimation, the cumulative amount is in excess of Ksh337 million every month.
Per year, teachers contribute at least Ksh4 billion for a medical scheme which is supposed to serve them and offer superior cover which the state-owned National Hospital Insurance Fund (NHIF) cannot offer. The above figures have not included job group J, Q and R.
Therefore, the total amount collected by the medical scheme is much higher than we can imagine.
You expect some good service and profits with such amount going towards a certain medical scheme, but for teachers, it is one of the biggest nightmares for those who get the services.
Worse still, the services are unavailable in some parts of the country, forcing teachers to dig deeper into their pockets even after paying for medical insurance.
“While the scheme has some sound inpatient services, the outpatient services are terrible. You are limited to poor quality services offered by Bliss and Ladopharma. The services provided by these providers are low-quality drugs and poor diagnosis yet you cannot opt for any other,” says a teacher who sought anonymity.
Some hospitals nurses and doctors are surprised if you tell them that you are supposed to be covered under this scheme as they have never heard about it, teachers from these areas say.
The scheme is offered through a little-known Medical Administrators (K) Limited (MAKL), which was founded in 2018 before the AON Minet contract was renewed in 2019 for three years. One of the shareholders of MAKL is Jayesh Saini, a man facing several scandals in the medical sector in Kenya. At one time, he was accused of supplying fake drugs to the Kenya Medical Supplies Agency. He owns his shares through Bliss Healthcare, as earlier revealed by Kahawa Tungu.
“In my area other than Bliss we have only one Minet accredited facility. A teacher can only be treated there once per month for outpatient and maximum is Ksh1500. out of the Ksh1500 consultation is Ksh500 so teachers are forced to pay from their own pockets. When we ask the hospital why they are mistreating us they are claiming that Minet delays in payment of claims and accused them of corruption,” says another teacher who sought anonymity.
Another teacher who spoke to Kahawa Tungu was detained at Nightingale Hospital in Kisumu, as the management demanded that they clear their bill, despite having been treated under the scheme.
“Currently am still in the hospital without hopes of being cleared. They want us to pay the rest of the money yet we have not used inpatients package, dental, optical n outpatient. We have only used maternity and now we are requesting them to allow us use inpatients package(sic)” she says.
The Insurance service, surprisingly, does not cover any patient in public hospitals, according to sources who spoke to us, from experience.
“I have a cousin in ICU at Embu Level 5 Hospital. She has been in a coma since September after a fatal accident. She is recovering well after successful head surgery. Now the hospital wants to discharge her for her to recuperate at home. The hospital bill of above 1.2m we were hoping the NHIF and AON Minet to cover and clear since the girl’s parent are both teachers under TSC. To our surprise, NHIF caters for only 160k AON on their part are not paying a penny claiming its a government hospital. Of which this was not communicated to the parents when they reported to the insurance then only now they are giving that info when its due to pay the medical bill (sic),” says a resident in Embu.
Still, in Embu, a teacher who spoke to us says that he lost his child during childbirth, after Embu Children’s Hospital, which he took her wife, refused to attend to them since they had suspended their contract with Minet, due to non-payment.
“On arrival, we were directed to doctors room outpatient side, where she was examined and they declared her due. We inquired on use of Minet insurance but we were informed that the hosp had suspended its operations. We were advised to pay an admission fee of 5k. I paid after seeing another patient being turned away, at around 11.30 PM. They had even requested me to take her to another hospital either liberty or county where Aon was still in operational. I paid the amount and she was admitted and within 30 minutes she gave birth. We lost the child though. This was around 2 am in the morning,” he narrates.
The teacher had to pay a total of Ksh26,000, even after the mediocre service. The amount was reviewed downwards after NHIF paid for the bed. Efforts to follow up with Minet were futile, since they had shifted their offices severally in Embu, and when he finally got them it was through phone. They promised to follow up the issue, but up to date, nothing has been done.
In another case, a teacher who took her child to Gertrude Hospital was unable to receive treatment, even as the hospital demanded that AON-Minet authorises treatment.
“We’ve tried calling the Minet Kerugoya (Tr comes from Kirinyaga) but phone busy, we’ve called the Minet Nairobi centre but she has been told she can’t be treated without a referral letter from a hospital in Kirinyaga county, she has told me she had to cough her money and pay cash,” says a ‘friend’ who spoke to the teacher.
“The Minet medical scheme is not a bad scheme, initially it had kicked off well, but after the second contract, things are worse, hospitals are withdrawing from the scheme,” she adds.
While teachers are suffering under TSC and the scheme, the Kenya National Union of Teachers (KNUT), Kenya Union of Post Primary Education Teachers (KUPPET) and the recently introduced Kenya Women Teachers Association(KEWOTA) are silent.
Word has it that the three unions are part of the deal, and top officials have been bribed to keep mum about the deteriorating situation.