Universal health is not something that one rolls out. Many of our people are not interested in learning or understanding what is universal health. The government’s approach to universal health involves getting people to pay monthly contributions to the National Hospital Insurance Fund (NHIF). This approach is faced with two distinct difficulties: (a) the people working in the government are indifferent about where people get money to contribute to the Fund, and (b) the people working in the government are oblivious of the micro-economic problem of prioritizing family budget.
People working in the government are indifferent about where people get money to contribute to the NHIF
A huge problem in Kenya, is that unemployment rate can be as high as 90%, for people graduating from university, in certain disciplines. Millions of market-ready people cannot find jobs. It is extremely naïve to ask someone without a steady income to make monthly contribution to a fund. From where would he/she get the money to pay.
As you can see, people in government talking about universal coverage, without talking about increasing access to high quality well-paying jobs is the greatest nonsense of the present time. Indeed, because of this problem, it is practically impossible to scale NHIF. This means that NHIF is already fully saturated, and cannot grow beyond where it is right now. NHIF is already covering people with steady income, who are less than 20% of Kenyans. The rest of the population is in subsistence farming or just barely making it through the day.
People working in the government are oblivious of the micro-economic problem of prioritizing family budget
Imagine a woman who makes a living selling vegetables at the local market. In a good day, she makes 500 shillings. In some days, she makes 50 shillings, in many bad days she is not able to sell anything. Guys from government come around and tell her: “Woman give us your 500 shillings. We will put it away for you so that we will pay for your medical care when you get sick. We will even pay for your family.”
She has to feed her family at least twice a day. She also needs to buy uniform for her kids going to school. She has pay school fees…..and the list of needs continue. Maslow (1943), taught us that people will meet their immediate basic needs before they can think about meeting a needs in a distant future. Insurance is for meeting needs in a distant future. Even if the lady in this examples agrees to contribute to NHIF because of coercion by people in government, it is quite obvious she will in a future date have trouble prioritizing NHIF over school fees and food for her children. She will default her payments.
Soko Janja helps to overcome both problems. Soko Janja is very interested in how local people make money. Indeed, the sole job of Soko Janja, fully developed, is to help people create wealth. About 14 million families in Kenya do not have access to health care. Should Soko Janja reach the 14 million families, and help put money in their pocket by facilitating market for local produce, products and services, then they would not have problem contributing to the health fund. As an electronic market, Soko Janja can set money aside into a health fund. Such money will go into a smart contract that will pay medical services. Pooled smart contracts from millions of families will operate as health insurance.