Category Archives: medical insurance

Make Innovation the Centre of your Business and Job or Face Disruption

These were the words of Brett King, a futurist and bestselling Author spoke about disruptive innovation to guests at a business forum at the Capital Club, Nairobi. He had been invited by KCB Group, Kenya’s largest bank, which he is advising on a digital finance strategy.

He said that companies that are based on innovation and technology ( E.g Google, Facebook, Alibaba, Baidu, have ten times more profit (~$500,000 per employee) than traditional companies of ($30,000 per employee) or banks ($50,000 per employee)  as they are more efficient at converting production to profits

Other comments:

  • Historically technology that is cool but disruptive ,is resisted and he compared Luddites who smashed factory machinery in England in 1812, to taxi drivers smashing Uber cars in France 200 years later.
  • He expected more contextualization of financial service a based on location and behaviour: e.g. walk into an Apple Shop and you get a finance offer on your phone about a new device you have been longing to buy.
  • Bitcoin’s ability to be a currency is hampered because owners of the coins are hoarding them like gold so they appreciate in price (which is now $1,000). They are not using the bitcoins to make payments which are what currencies are meant to do.
  • There’s a bright future for peer to peer (P-2-P) insurance (more than P-2-P lending).
  • The service jobs there today will be replaced by automation/robotics. But this creates even newer service jobs (every job lost to technology create 2.6 others), and students considering careers should ask themselves how they will compete with Artifical Intelligence (AI) or work in jobs that enable the future e.g. solar adapters.
  • Entrepreneurs should create businesses that take advantage of AI. The mid-2030’s will be an exciting time as there will be more energy from renewable sources than fossil fuels and more robots than humans.
  • On Kenya’s revolutionary M-pesa, which had facilitated the fastest financial inclusion shift in history, he said it was clunky as it was designed for feature phones.

Lipa Kama Tender

hospital-bed

Lipa Kama Tender

This evening, Kenyan public sector nurses called off their strike after the government agreed to implement a collective bargaining agreement (CBA) deal. It’s been a painful week for patients around the country as nurses and doctors have been on strike at many public hospitals and medical facilities. Anyone who has spent time in a hospital realizes how much work the nurses do in terms of taking care of patients, alongside doctors – who themselves are still on strike, also awaiting the government to implement their CBA signed n 2013?.

The striking workers used the solidarity slogan “lipa kama tender” – Swahili for “pay (us) the way you pay (government) tenders” as a play on the widespread reports of the government paying out millions and billions of shillings of taxpayers and donor money in overpriced, corrupt, fraudulent tenders for supply of goods or services – some of which were for health-related equipment procurement, and which were flagged by an auditor who has since been removed from the sector.

Insurance vs Betting

Last week I got an email from an insurance company titled insurance vs. gambling. I deleted it immediately, but later thought about what it meant. Why is it that it is hard for vital sectors like insurance and pensions to get traction in this country? Their levels remain low, yet people flock to what are likely losers like sports betting, gambling and pyramid scheme.

Every time my cousins visit from the village,  I marvel at how many of them are into sports betting. They know teams in many obscure  soccer  leagues in many countries and make bets to fill out their winning brackets. They all remember their big wins, “Kshs 8,000” or “Kshs 22,000” that was sent directly to their mobile phone as they slept, but they can’t or won’t tell you about how much spend every week to get those winnings.

Pic by MediaclubSA of street in Molimode (from AfricaKnows.com)

Pic by MediaclubSA of street in Molimode (from AfricaKnows.com)

As I started to write this I was at a doctor’s office. I ate some food and ended up with  a bad stomach. A mentor had warned me that bad food and the flu were “putting down” a lot of people in Nairobi now, and so I went to get some help.

Earlier, I had been at Coop Bank to speak to them about their various medical insurance products. They have high-end packages and low-end ones that costs Kshs 15,000 to cover a family for one year, and with just Kshs 9,000 to start, a family is covered with both in-patient & out-patient care.

For small companies they waive all waiting requirements and pre-conditions and for individual joining from another medical cover plan, the same requirements are also waived. There is no co-pay (no money paid for treatment) and they are accessible at centres all over the country. It covers people goes up to 74 years and includes operations and treatment in India and South Africa, if a doctor recommends treatment that’s not available locally.

A typical doctors visit in Nairobi ranges from Kshs 3,000 to 10,000 for doctors visits, medication and lab work (if required). Every young person should have insurance, for themselves and their families such as the plans at Co-op branches and agents.

But back to the inspiration for the post. I also got an email from a popular sports betting company. It came just a few days before the final of the Euro 2016 soccer tournament, and listed some of the odds that could have won me some money. Besides the outcome of the game, which few could have predicted, here are other bets that one could have placed:

  • Portugal vs. France: 1 (4.13) X (3.10) 2 (2.02 [whatever that means!]
  • Cristiano Ronaldo not to score. 1.24 
  • Cristiano Ronaldo to score first and Antoinne Greizmann not to score. 8.82
  • Both Cristiano Ronaldo and Antoine Greizmann to score anytime. 8.70
  • Renato Sanches to score anytime. 8.50
  • Paul Pogba to score anytime. 4.50
  • Over 2.5 goals: 2.60
  • Both teams to score: 2.20 

Medical Investments in East Africa Redux

It’s been 5 years since reviewing the annual results of Nairobi hospital, and since then it’s almost doubled in size.
  • The hospital has revenue of Kshs Kshs 7.5 billion (~$75 million)  up from Kshs 6.9 billion in 2013.
  • It had a surplus of Kshs 1.58 billion (~15.8 million) up from 1 billion in 2013.
  • Assets were  Kshs 9 billion up from 7.5 billion in 2013
  • The hospital invested Kshs 1.2 billion in the last year, including 621 million on building, and 547 million on equipment.
  • Their doctor efficiency target is 4 patients per hour per doctor, an improve from the current 17 minutes (it’s also 21 minutes per patient with ambulance cases)
  • Other revenue sources were the pharmacy with sales of Kshs 2.15b from 327,000 prescription and the laboratory which did 630,000 lab test generating 1.2 billion. It also made 1.1 billion from bed fees.  They had 277 beds available (up from 269 the year before) and admitted 17,558 patients
  • They spent 1.5 billion on medicine, and 1.2 billion on staff towards a total of 4.4 billion in direct expenses. 

Is Wealth a Disadvantage to Health?

A guest post by Joshua Arimi of Arimi Foods

It is now widely accepted that there are ‘diseases for the rich’ or ‘western diseases’ and ‘diseases for the poor.’ A World health organization’s (WHO) 2011 report published in June 2011 which analysed the top ten killers in the world showed that, the rich are most likely to die from strokes and heart related diseases, while the poor are likely to die from pneumonia and diarrhoea.

Also in June, Kenya’s Daily Nation newspaper published an article derived from the WHO data with a catchy title ‘The rich more likely to die from heart disease’. Does it mean wealth is a disadvantage to health? No! – The ‘real wealthy’ are not the victims of heart diseases but the ‘average rich’.

When health and wealth are put in the same sentence, it is very important to differentiate between those that are in high income, middle income and low income categories. According to WHO report, highest number of those that die from ‘western diseases’ are from medium income countries as opposed to high income countries. This is contrary to the notion that wealth per se is the risk factor for heart diseases.

Out of 1,000 deaths related to strokes and heart related diseases;

• 39 were from high income countries like United Arab Emirates, United Kingdom and United States of America.
• 179 were from middle income countries such as South Africa, Nigeria, Thailand and Tunisia. i.e the number of people from middle class category that will die from ‘western diseases’ is three times higher than that from high income category.
• ‘Kenya together with Zambia, Zimbabwe and Tanzania are on the low income category and the majority will die from pneumonia and diarrhoea’ says the report. Ideally, a high number of the so called ‘the rich’ in the low income countries fall in the middle class category globally. This may explain why the rich among the low income countries have the highest prevalence of ‘western diseases’.

The WHO also found that while the USA is in the high income category, the majority of Americans who succumb to strokes and heart related diseases are the less wealthy. Other University research in the US found that when they compared wealth and prevalence of obesity, hypertension and related diseases, there was an inverse relationship between wealth and these diseases – meaning that less wealthy were more likely to suffer from them than the wealthy.

To understand why the middle income populations are most likely to suffer from stroke and heart related diseases, it is essential to outline the key major and contributing risk factors. Major risk factors are those that have been proven to increase risk of heart disease and these include high blood pressure, high blood cholesterol, diabetes, obesity, overweight, smoking, physical inactivity, heredity and age. Contributing risk factors are those that doctors think can lead to an increased risk of heart disease, but their exact role has not been defined and these include stress and alcohol.

Clearly, the major and contributing factors of heart diseases are results of lifestyles. The poor cannot afford these lifestyles, however, as they say, ‘poverty is not permanent’.

• Low income populations work extra hard to get out of the lower income cadre, while envying lifestyles of the middle income populations.
• As soon as they join the middle income category, they desperately imitate what they perceive as lifestyles of the rich. That is; eating on the go, consume fatty foods, processed foods, ready to eat foods, smoke, have high alcohol consumption, and assume sedentary lifestyles.
• On the other hand, the high income countries have always enjoyed these foods and lifestyles while in the middle income category and they have witnessed first hand the adverse consequences among their populations and peers. The rich countries are cutting on deadly foods such as high saturated fats, processed foods, high alcohol content drinks and sedentary lifestyles. Meanwhile, the emerging economies and the middle class among rich countries are embracing these renegade lifestyles full throttle.

For example, the biggest supermarket in UK and Ireland, Tesco does not stock any solid cooking fat or hydrogenated cooking fats which are associated with high trans and saturated fats. On the other hand, solid cooking fats occupy the biggest shelf space in supermarkets in Kenya. Also beer drinks sold in developing countries have higher alcohol content than their counterparts in developed countries.

‘I have to enjoy life’, ‘I don’t have to live a boring life’, and ‘I have to live like a rich man’. These are common justifications among the middle class when engaging in life shattering lifestyles

It is not true that the rich are most likely to die from heart disease. ‘Out of 13 million people who died from stroke and heart related diseases worldwide in 2008, 1 million were from low income countries, 2 million were from high income countries and 10 million (5X higher) were from middle income countries’ adds the WHO report. And, in the high income countries, it is their low income population that is at the highest risk of heart diseases. In the middle income countries, the majority are at risk. In low income countries, the so called ‘the rich’ are at the highest risk.

Overcoming Risks Posed by Wealth to Health: Many will argue that with wealth you can afford the medication. However, health is not a financial muscle competition and prevention pays dividends than struggling to cure.

Understanding the consequences of different lifestyles brought about by wealth is key to coping well. The majority who move from low to middle income category of wealth are ill-prepared to cope with what wealth throws at them. It is important for governments and other agencies to educate their people on relationship between health and wealth and if possible entrench the course in school curriculum.

Simple lifestyles tips to opt for include cutting salt intake, a adopting regular exercise regime, cutting back on fatty foods (in particular saturated and trans fats), moderating alcohol consumption and balancing between work and social activities.