By Billy Mijungu
The use of Social Health Insurance Fund (SHIF) to finance private healthcare has become a contentious issue, raising questions about the proper allocation of public resources. While private healthcare can complement public systems by offering specialized services, the continued and significant funding of private health facilities with public money poses fundamental contradictions. Other essential sectors, like education, agriculture, housing, and infrastructure, do not receive public funds in the same manner. This brings us to a critical discussion: why should social health insurance exclusively fund public health ventures rather than extending those resources to private healthcare?
- A Broader Perspective: Public vs. Private Sectors
Public Resources in Other Sectors
In many areas of public service, the government ensures equitable access by investing exclusively in public institutions:
Education: Public money primarily goes toward funding public schools, ensuring that all children have access to basic education. Private schools, even though they cater to a section of society, do not typically receive direct public funding. They rely on tuition and private contributions, not government subsidies.
Agriculture: Public resources support state-run agricultural programs or cooperatives designed to uplift the broader community. Private farms or agribusinesses usually rely on their own resources or private financing.
Housing: Government funding is used for public housing projects to provide affordable housing to lower-income populations. Private developers, while essential to the real estate sector, operate without direct public funding.
Infrastructure: Governments build public roads, railways, and public transport systems to serve society at large. Private roads, tolls, and transportation services are typically funded by private investors.
Private Healthcare: The Outlier
Yet, despite the precedent set in these other sectors, private healthcare providers are often the beneficiaries of public resources through Social Health Insurance. This creates a stark contrast: while other private entities must survive through self-financing or private investment, private healthcare facilities are consistently supported by public funds meant to serve public interest.
- Why Public Funding for Private Healthcare Is Problematic
A. Misallocation of Public Resources
Social Health Insurance is meant to ensure that all citizens have access to healthcare, but when those funds are directed toward private hospitals and clinics, they are often diverted away from public facilities that serve the vast majority of the population. This misallocation:
Favors wealthier individuals who can afford private care, leaving vulnerable populations reliant on underfunded public hospitals.
Exacerbates inequalities by providing financial backing to private providers, which can charge higher fees, undermining the principle of universal, equitable access to healthcare.
If public schools or public infrastructure were neglected in favor of funding private counterparts, there would be a public outcry—and rightly so. The same scrutiny must be applied to healthcare. If social health insurance can serve private healthcare, why not private schools or private roads? The inconsistency in these policies highlights the unjustifiable favoritism toward private healthcare.
B. Profit vs. Public Service
Public healthcare facilities are designed to serve public interest, while private healthcare operates on a for-profit basis. Using public money to support private healthcare ventures introduces a conflict of interest. Private providers, though offering essential services, often prioritize profit margins over broad public health outcomes, leading to:
Higher costs of care, which in turn inflate the expenses covered by social health insurance, straining the system.
Selective treatment of patients, where private providers may opt for more lucrative cases while avoiding complex or expensive treatments that would impact their profitability.
In contrast, public healthcare facilities operate on a non-profit basis, ensuring that every citizen has access to healthcare regardless of their financial situation. Public funds should remain focused on enhancing public service, not enriching private enterprises.
- A Focus on Public Ventures: Ensuring Sustainable Development
A. Universal Access and Equity
When public resources are directed solely toward public healthcare, they ensure that all citizens, especially the poor and marginalized, have equal access to quality health services. Public schools, for example, are open to all, providing an inclusive education system. Similarly, public healthcare should be strengthened by social health insurance to serve all citizens equally, ensuring that no one is left behind in accessing critical healthcare.
Private healthcare, like private schools, is an option for those who can afford it, but public resources should focus on universal, non-discriminatory access. By exclusively funding public ventures, governments can ensure that public healthcare systems are well-resourced, well-staffed, and capable of serving everyone.
B. Public Accountability and Sustainability
Public institutions are accountable to the public through government oversight, audits, and regulations. Private healthcare facilities, however, operate with less public transparency, meaning that public funds allocated to them may not always be used efficiently or in the best interest of citizens. By restricting social health insurance to public ventures, we ensure that the allocation of funds is transparent, justifiable, and traceable, bolstering public trust in the system.
In sectors like education, housing, and infrastructure, public funding is tightly controlled and directed toward public institutions that are transparent in their use of resources. The same should hold true in healthcare.
- Preventing the Commercialization of Essential Services
Healthcare is a public good, not a commodity to be traded for profit. When public resources are used to fund private healthcare facilities, it commodifies healthcare, shifting focus from care to profit. This privatization trend threatens to turn essential services into products accessible only to those who can pay, leaving public institutions underfunded and overstretched.
If public resources were similarly allocated to private schools or private housing, it would lead to an over-commercialization of essential services, further widening inequalities. Public funds should be directed toward public goods, ensuring that basic needs are met for every citizen without creating barriers to access based on financial means.
- Encouraging Private Investment Without Public Dependency
There is a clear role for private healthcare in complementing public systems, particularly in offering specialized services. However, like private schools or private infrastructure projects, they should be funded through private investment rather than relying on public resources. Public-private partnerships can exist without undermining the public health system, ensuring that private providers add value without drawing essential funds away from public services.
Conclusion: Public Resources for Public Good
The essence of social health insurance is to create a system where healthcare is accessible to all, without barriers of cost or inequality. By exclusively funding public health ventures, we can ensure that public resources are used effectively to serve the common good. Just as we do not fund private schools, private roads, or private housing with public money, we must ensure that private healthcare remains self-sustaining while public healthcare receives the investment it needs to thrive.
This approach promotes equity, transparency, and sustainability, ensuring that public funds are used where they will have the greatest positive impact on society.
