| Health and Lifestyle | The cost of healthcare

[00:00:08]Welcome back and thank you [music] for staying with us on health and lifestyle.

[00:00:12]Still today we want to talk about the cost of healthcare and why does it seem like many Kenyans and many households cannot be able to afford quality health care in our country. There's a lot that has been done from insurance to you know just trying to elevate the incomes of Kenyans so that they can be able to afford but it is still a conversation that we are still having because not so many Kenyans can walk into a hospital today get the services that they require and be able to pay for it without feeling the pain and that's why we want to talk about that and I'm hosting this particular morning Albert Mandela is a healthcare investment entrepreneur being the CEO of Luton Medical Hospital. A man who has been listed top 40 under 40 Kenyans making waves in the healthcare space and also ventured in the pharmaceutical industry. He also has a background in banking. I wish I had the whole day to unpack who he is but thank you for creating time with us today.

[00:01:07]>> Thank you. Thank you very much.

[00:01:08]>> Yeah. So when you talk about the cost of healthare as an investor in the industry, what what comes to mind?

[00:01:15]>> I think the fact that healthcare is expensive. All of us knows that the cost of healthare is expensive. But the other things that we can do to make it more affordable or easier for us, the most important thing is prevention.

[00:01:28]>> Prevention is the most important thing about healthcare. And that is where I feel that resources should be put in.

[00:01:33]How do we make sure that people don't get sick? How do we make sure that we also able to make sure that people who are sick, we able to screen them earlier. So there are very many ways that we can be able to to do that if you allow me to. The first thing >> before we get there >> when you say expensive >> what do you mean expensive so that Kenyans who are watching you can see whether >> really that pain that they feel is what exists in the sector when you say healthcare is expensive where is this expense where is this pain where is this weight uh you know coming from >> it's just the cost >> the cost expensive I I always say that if you look at other sectors for example if you go to a restaurant it will be very difficult for you to spend $100,000 in a restaurant.

[00:02:17]>> Mhm.

[00:02:18]>> You know, but if you go to a hospital, a 100,000 is just the beginning. There are very many factors underneath that makes healthcare expensive. You know, you look at the cost of drugs. How much does it cost you to buy drugs? There are very many Kenyans who are not able to afford drugs. The procedures itself, there are so many Kenyans are not able to do the procedures because the underlying factors makes healthcare very expensive.

[00:02:41]>> So the cost and it's not just a Kenyan thing. It's a worldwide thing. I've read articles and I've seen situations where healthcare has made people bankrupt across the world. It's just not in Kenya. You remember the famous stories about Joe Biden, the former president of the United States. When his son was sick, he had to sell, he almost sold his house to take care of his son. So, healthcare is an expensive enterprise, an expensive business all over the world.

[00:03:05]>> But there are ways that we can be able to make it more affordable and more universal for >> for everyone. I hope we will talk about that because that's why we are dissecting this subject. But tell me a bit about maybe a personal story that you have interacted with when you've in this space of healthcare that really was a matter of cost visav life that really touched your heart and you felt like something needs to be done to just make sure that health is affordable. Anything that that strikes your mind that was really unfortunate about how expensive healthcare is. I think there are many I think there are many including [clears throat] myself when I was a kid I got an accident at 8 years old and I can remember that we were growing up I was growing up in Kisumu and I had to have an orthopedic uh procedure and back then we could not get plates we talk about 93 94 >> I was fortunate enough that my dad was able to afford or was having the connections to we had to bring plates from Nairobi all the way to Kisumu and a surgeon to be able to take care of of me. These are things that we see even today. We have seen very many people come to the ICU and the bill goes to 10 million 15 million. Very few Kenyans can afford anything beyond 100 or 200,000 in terms of cost. If you're coming from your pocket, we all know how much insurance usually cover. Most Kenyans are not having insurance that is above 1 million shillings. So the moment you go into an ICU situation as a patient, you are always in a backfold. You always have to look for money. you have to do a rabe you have to sell an asset so every single day we deal with those situations we have people that we discharge every single day and someone is not able to raise 200,000 or 300,000 or 1 million so Kenyans are suffering every day in terms of being able to afford healthcare we've seen people who come and buy they have been given a particular medicine for 3 weeks someone is only able to afford for 2 days or for 3 days >> so they skip they take today >> or half do because that's what they can afford afford. So you end up having situations where you're not getting better. Many people die because of this situation of cost. And that is why I feel like it's a very important conversation for us to have so that we able to mitigate and find ways of helping Kenyans.

[00:05:18]>> When you look in your analysis of this cost, is it man-made or is it's justifiable? Walk me through a patient walking in from the admission to consultation to maybe uh being being discharged to the drugs. Where does this cost come from? Is it justifiable?

[00:05:35]>> It's a combination. It's justifiable.

[00:05:37]It's a combination. There are things that we can do, but there are things that we cannot do.

[00:05:41]>> Take an example of a consultant.

[00:05:44]>> How long does it take for someone to be a consultant?

[00:05:46]>> Years. How much investment is it? How much is medical school.

[00:05:50]>> Medical school is very expensive. You've taken 12 13 years of your life dedicated to being a consultant. 15 years. Some even 20 years to be a consultant. How much do you reasonably expect this person to charge you for consultancy?

[00:06:02]Don't expect him to charge you 500 shillings.

[00:06:03]>> So sometimes you've gone to a hospital, you only have 3K and that is what is needed for consulting.

[00:06:07]>> That is what is difficult.

[00:06:08]>> You've not been told what is wrong.

[00:06:10]You've not been told what medicine you will need or which procedure will be required.

[00:06:14]>> You are that just consultation. Now you move to the next step. Assuming you've come and seen the consultant and you have the 3,000 shillings. Then the consultant tells you that I want to you to get an MRI.

[00:06:24]>> How much is an MRI?

[00:06:25]>> A machine. An MRI machine is about 1.52 $22 million.

[00:06:29]>> You're talking about 300 300 million >> just to buy it. just to buy it >> when it comes into the country.

[00:06:33]>> Now, this you're talking as an investor.

[00:06:34]>> As an investor, it's 300 million for me to buy an MRI. Now, I'm taking you through a process to understand how the cost comes in. When the machine comes in, I have to pay K taxes.

[00:06:45]>> Taxes for MRI is 17 18 million shillings.

[00:06:48]>> I have to pay KPLC to get a transformer.

[00:06:50]I have to pay 9 million, 10 million shillings to get a transformer. I have to pay for everything to the place. So, the whole investment is 400 million shillings. I am definitely if you look at 400 million shillings. How much am I going to be able to charge for me to be able to get back the 400 million shillings that I've invested as an investor?

[00:07:07]>> I have to charge you 20 30,000 shillings per procedure for me to make business sense >> and that's where the cost of healthcare comes in. It's very very expensive to buy and to invest in a in a health facility. I always say that it's easier to invest in a banking or even insurance when you look at capitalization than to invest in a hospital. Hospital stores are highly capitalized. If you're looking at the building, specialized building, the way the gas is, the way the plumbing is, the way the electric uh situation is is different. You have to look at the stairs. You have to look at how you're going to have the lifts, the patient lifts. They have to be electricity. The patients have to feed.

[00:07:45]There's laundry to be done. There all these things have to be done. So, the cost of healthcare is brought about by the underlying factors of the cost that I put to put the infrastructure in place. We haven't even looked at the employment cost. A normal hospital has very many employees. Actually, our biggest cost is employee cost. Reason is everything is specialized. Someone who works in the laboratory cannot go and work in the theater.

[00:08:09]>> Someone who works in the theater cannot work in the ICU.

[00:08:11]>> So every sector or every department has an employee unlike other sectors where you can double have double roles. In a hospital, you can't. If you are a lab technologist or a lab, you can't be a pharmacist. M >> so you have to pay the pharmacist, you have to pay the lab, you have to pay the radiologist, you have to pay the theat nurse, you have to pay the surgeon, you have to pay the physician. So it is a highly I mean cost is very high for hospitals. So that becomes the problem.

[00:08:37]Now when you go to the other issue that is there is that you also have hospitals struggling with being able to get paid.

[00:08:44]Apart from cash patients not being able to afford, we have big receivables. If you look at the hospitals, the receivables are massive. You have patients who have come in the bill is two 2 million shillings. They cannot pay. They have to go home. You have to give them a payment plan. Time to sell their land. So all that sits in your book as debt. Insurancees have to go through the claims process for them to pay you. You're waiting for 2 months, 3 months, 6 months. But I have to buy the medicine to give the patient.

[00:09:09]>> Mhm.

[00:09:10]>> Because it's a matter of life and death.

[00:09:11]>> It's a matter of life and death. I have to have medicine every single day of my in the in the facility because I have patients.

[00:09:17]>> The patients don't care whether insurance have paid me or not. So what does that mean? I have to go and borrow money to be able to buy the drugs. So there's a 20% 30% finance cost for me to be able to sustain my facility. I have to pass down that cost to to the patient.

[00:09:33]>> Now you end up that something that should have been 10,000 shillings ends up being 25,000 shillings because of the factors that are in in between.

[00:09:40]>> Yeah. So, so, so for a patient who is now watching from outside not not inside for you it's you are an investor so you understand how the system works and there's always this common phrase easy hospitality you've had these mas even at the waiting bay there what do you tell them especially private hospitals >> I think >> that there's always that opportunity that they want to make money out of your illness >> I think it's a misconception I think most of us investors or not who are in the health facility or in the health business are there for a reason. We also human beings. We have people who are sick. We have been sick ourselves. I don't think the motivation of us investing in the hospital business is to take advantage of anyone. You understand? We ourselves, we have parents who are sick. We have colleagues who are sick. We have kids who are sick.

[00:10:27]It's not our business to go and decide to make money from people. Actually, what we are doing is bridging the gap.

[00:10:33]>> Imagine a situation where we never have private hospitals in this country or anywhere in the world. All of us have to rely on the government facilities or the faith-based facilities. It's not possible. We are just bridging a gap that is there between what the government is able to provide and what the demand is for us in between. And we also doing it from a compassionate point of view. We're doing it from a point that we are able to provide Kenyans.

[00:10:55]Actually, one of our biggest joy is the fact that you get a text message from someone saying, "Thank you for taking care of my mom. Thank you for taking care of my dad. Thank you for taking care of my kid." It gives us joy. So I don't think the idea that we are just there to take advantage is what should be done.

[00:11:09]>> But is it like a 100% clean bill of health in every case? Let's let's talk the truth. Some private hospital there's been reports that have been done that have shown even insurance fraud in some of these facilities >> like in everything else there are people who are not there with good intentions >> across uh businesses across the world that people who are not in good intentions. But I will speak for myself and from other people that I know the people there who are with good intentions that we are not there to make money from fraud. If someone is going to invest this amount of money in a business, he's not going to start selling for you a drug of 1,000 so that he can make mark that money. No, it has a long-term strategy. What is it that we are going to be? Therefore, some of us are in the business for value. You build a business and later on exit. So there are so many other factors that are involved. It's not a matter of I want to make money by selling for you a drug that a particular price other than the other price that is is required. So of course there people have given us bad name in the industry but most of us are there for good intentions.

[00:12:08]>> That's why I asked is this cost 100% justifiable because in some cases it it's a man-made problem thinks that if there are proper systems and and and safeguards then the patient will not have to incur some of this cost. And we want to talk about what should be done then to lower the cost of healthare because we all agree it's skyrocketed.

[00:12:29]It's beyond reach for many patients and so many Kenyans have lost their lives because of not being able to afford the quality healthcare services that they need. But let's talk about what sh was supposed to fix, what insurance is supposed to fix. Yeah. Isn't isn't that what where we were going? Isn't that the dream that was sold? Wasn't that the promise that uh the country was given that healthcare is going to be affordable? that it's going to be accessible since it was um introduced. I think it should be a year or so ago as private players. What is your analysis about how the transition from the the NHF to the social health authority has played out?

[00:13:09]>> I think like just before I talk about SHA and um uh universal healthcare, there's this misconception that pricing is just we just dictate pricing. No, healthcare is highly regulated. We have contracts. Remember SH for example have their price list. They tell you you have to sign on this price list. This is the price that's negotiated. They've done their costing. Same as insurance companies. I'm just not going to come here and tell you as a consultant I'm going to charge you 15,000 unjustifiable. No, there's market rates and they're highly regulated and Kenyans are also relatively very very educated and aware. Most Kenyans before they come to you they'll ask you how much is it 3,000. he'll go to his >> the check >> check how much is the other hospital charging me so Kenyans are really educated and regulated so healthcare is also regulated in terms of pricing we just don't come up with those prices out of nowhere >> now is I proceed and go into the issue of SHA I don't think there'll be any healthcare in this country if there's no sha >> mhm >> sha has played a very big role for us as facilities and for Kenyans people don't realize >> most people you only realize when you come to the facility every single day If you have people walking in and they're surprised at how much SH is covering for them in terms of the procedures, you have a procedure of 200,000, SH is paying for you 130. So you're only left with 70,000. Some procedures are even 100%. Let's look at diialysis for example. Patients walk in and walk out without paying a single shilling. And this is a lifetime disease or a lifetime situation. Sometimes people go all their lives doing diialysis. And SHA pays for you 100%. How many Kenyans can pay 20,000 from their pocket every single week for the rest of their life? They're not able to. So Sha has done a very commendable job in terms of coverage of what it provides. Definitely there are issues that we have with it. For example, delays in payments which have been there. You've seen it in the media and everything else. cuz I was wondering, you know, we which people which facilities because we've had private hospitals decrying the lack of reimbursements, the the long time it takes for them to get approval.

[00:15:12]>> It's it's delays. I mean, we like my business, we do 60% is SHA. So, we are reliant on SHA business. So, if you're doing 60% of your business as SHA and you're not getting paid on time or you're getting 50% of what you're supposed to be paid, then it becomes a problem. But definitely there are issues why they are also delaying. First of all is claim process. A claim process is not an easy process. They we have to they have to justify what they're paying us.

[00:15:38]So it has to go through a process a manual review at what we have provided for them. So that process is what SH has been working on to to improve and once they improve that once they digitalize that such that when I put in my claim I don't have to wait for 60 days for someone to physically review my claim then it becomes easier. But from my experience they have done a good job in terms of reimbursing us in terms of given that these are new they're talking about a national rollout process. You've seen that even in elections when we have a national roll out pro process it it's very difficult. You see that in education. So for them to be able to do that so far is good >> but their chances of improvement and for me my only worry with SHA is they need to improve on their stakeholder uh stakeholders engagement. We need to be asked what are the challenges that you are facing? What are the things that you need to do? Because also as we have ideas so once and I've seen that I think last month we had a meeting with the with the management of SHA and the minister of health and they gave us a forum to to air out.

[00:16:39]>> So Albert as we speak this morning have the issues been resolved? I've covered I've covered health and in SH specifically and and and even when the roll out was being done for quite a while and I remember one of the biggest uh nightmares for private hospitals was was that exactly that the the the approvals the they were not getting reimbured and there was a time even they were threatening not to um admit patients who are coming with the SH as their insurance cover. Have those issues been resorted and if sitting this morning here what are the quick quick pressing you know challenges that must be addressed so that this uh is not counterproductive.

[00:17:17]>> I think they have not been addressed fully.

[00:17:19]>> They have not been addressed fully to be honest. They have not been addressed fully. We have very uh issues that we have to work on. One of them is rejected claims.

[00:17:27]>> We've had system rejected claims and most facilities have talked about this and we've brought our concerns to the minister and to the SH leadership and they're aware of this. you have your claims rejected based on a system and you're not given a chance to re submit your they say you don't have a doctor's note or whatever it is. The other day we had a meeting and they said they're going to manually review all these things and build on it. So when you have about 9 billion shillings rejected claims in the whole country definitely there's a strain on that. Another issue is about how long it takes for the views to be done and >> so rejected means it's not going to be paid. you're not given a chance being and I don't think that is a fair way of doing things. I mean people can have >> reasons why a claim is rejected and all over the world if you look at the systems you are given an issue you are given and there's a difference between a rejected claim and fraud fraud is a deliberate attempt to get money from the from from from a provider without providing a service or illegally. That is fraud. That is dealt with separately.

[00:18:27]If you're doing fraud, you're supposed to be taken to the police and taken to court. But if I put my claim and you feel like there's a document I need to add, you simply tell me, can you please give us a doctor's note on this to justify this claim? Then I give it to you. And if you're not satisfied, then you say it's okay. Why is it that we don't have a tribunal? For example, >> even K, there's a tribunal. If I feel that there's an issue as a taxpayer, I can go to the tribunal, I feel that K is oppressing me on this particular issue and they listen to both sides and they decide. But for us we don't have once is rejected is rejected. So you have so many facilities who are not able to provide service because of the burden of rejected claims. So I feel that is one thing that we have to work on. Another thing is pricing. The other day we went through a negotiation process for civil servants. In as much as we appreciate that they also have a cost but we also have to we looked at and said what is your cost? So what is happening is that most facilities are not able to provide a service at a particular cost. This cost should be negotiated and should be at market rate. And I don't feel personally I don't see that reason why you want to force facilities or providers to provide a service at a particular cost when they can't do it.

[00:19:36]What's going to happen? The civil servers are going to come to the facility and we're not able to provide that service for them because we're not able to afford it. It should be a case where we have a honest conversation >> and one thing that people care about their health. I don't think there's anyone who is going to refuse to pay if you're having a honest conversation with them.

[00:19:54]>> You tell them we are only able to cover you up to 100,000. Anything beyond that, please find a your own way. People care about their health. No one wants to die.

[00:20:03]Everyone wants to make sure that they're okay. But they need honesty. Don't lie to us and tell us we are going to cover you 100% when you know the cost is not able to be possible. So for healthare I feel like we need an honest conversation. What is it that the government can provide for us and what is it that they cannot provide for us so that everyone is comfortable the patients know the providers know and the whole country knows that this is what the government can provide. And I feel that is a conversation that we have not really been able to >> that's where we should go. Is that why probably some private hospitals prefer the private insurance? You'd go to some facilities and they would reject SH and they'll tell you that they are not taking >> because they have to stay alive. I mean at the end of the month I have to pay my employees. At the end of the month I have to pay KPLC for my electric bill.

[00:20:48]>> At the end of the year I have to pay K for the taxes. So for as a business I also have to look at the business part of it. Is private hospital private insurance give me a better pay compared to the public one? Yes. How do I find a balance? Because also we must also remember that this is not just a normal business. This is a business of caring for other people, your fellow Kenyans, your own people. So you have to find a balance. How much is it that I can be able to go in terms of providing for people and then how much am I able to go as a business to be able to survive. So that's why we always have a dilemma. how to balance between providing a service because you are in that industry and also being sure that you're alive as a business.

[00:21:27]>> All right. Let's leave the insurance conversation aside for a little bit. Uh currently as as as as players, how are you balancing commercial interest and public good when it comes to health for patients who cannot afford? Uh there are people who feel public hospitals are for the rich. They cannot be able to afford.

[00:21:45]You go there and you should be ready to sell your land.

[00:21:49]How do you usually help patients?

[00:21:51]>> That is not entirely that is not entirely true. If you go to private hospitals and maybe you can do a survey and maybe it's time someone has a question about this and ask them how much of debt do you have from people who have come to the facility and not paid.

[00:22:04]You'll be shocked at how much we have given out to society because basically that is money that you're not going to recover.

[00:22:08]>> Yeah. So let's talk about what you do to cushion patient. So most most most I'm sure you've seen this most of um hospitals have now come up with foundations which I feel like Kenyans should be able to to support. The foundations are there so that when we have a patient who is not able to afford, we can be able to get that from the foundation. We've seen it. I saw a case the other day of a big hospital that had a patient who had not paid 30 million >> in in in in in cost and they went to their foundation and paid for the patient 23 million from their foundation. So we in must also have the support that from from Kenyans in these foundations. It helps. We've seen so many programs that hospitals have started in the foundation. For example, as we're doing a fistula program in our foundation, >> most women especially in marginalized areas and in low inome areas cannot afford a fistula procedure is 600,000.

[00:22:59]>> How many Kenyans can afford 600,000?

[00:23:03]>> So we've set up a foundation that does fistula for for women.

[00:23:06]>> The corrective surgery.

[00:23:07]>> The corrective surgery. And these women are feeling better because they're able to we provide five six of them. We look for them. We do for them a corive surgery for free from the foundation. So hospitals are also doing things within them to help these people. We have so many people that come in and you're not able to pay the bill and we allow them to be treated and to go without paying any any bill. So we are doing our our part as private hospitals to also provide to the to the society. Mhm. As we talk about bringing the cost down, what what public private partnerships can work to bring this cost down, the cost of healthare and earlier when we were starting the program, you also mentioned something about prevention as a as a as a way to bring the cost of healthare down. Tell me more about about that space.

[00:23:52]>> I think there are various things that we have not actually done to bring the cost of healthcare down. First, I don't believe that we should be paying taxes on equipments, medical equipments. It doesn't make sense for Kenyans to still be paying tax on medical equipments.

[00:24:06]These medical equipments are coming to give us a service that will significantly reduce the cost that we charge for facilities. We should not be paying taxes. Why should hospitals be paying corporate tax for example?

[00:24:17]>> It doesn't make sense. Let that 30% corporate tax go back into the costs of Kenyans healthcare and then reduce the cost for Kenyans to afford. There are things that we need to do the partnership between private and public.

[00:24:29]One of the most important things that we have to do is vaccination. Vaccination helps a lot in terms of health care, preventing guys from getting sick.

[00:24:37]Screening. Screening is important. We need to screen early. Cancer screening.

[00:24:41]These are things that are done by private hospitals, public hospitals, and in partnership we can be able to to do them. So for me, I feel like one of the things to reduce the cost of healthcare down is taxes. We must review the taxes on healthcare. It has to be why should I be paying taxes on drugs for example it doesn't make sense let that 10% 15% that I'm paying on tax go back as a benefit to a patient >> you understand if you reduce the cost of healthcare by 10 15 20% you'll significantly have reduced the the cost of for most Kenyans >> secondly let's do things like screening let's do things like vaccination so that every Kenyan is able to access vaccination access screening so that they able to understand and to know themselves better before it gets to a a bad case. I've also seen a lot of Kenyans now get involved in exercises, physical exercises, lifestyle. People are really concerned about their lifestyle. These are the things that we need to do so that you don't reach wait for the point where you get sick. You do all these things before then you're able to then that will significantly reduce.

[00:25:42]So let the hospitals be for those people who are actually sick. But most of us Kian will try and thrive prevent these things early.

[00:25:50]>> You remind me of a saying once I saw you prevent Dr. Hill Dr. treats, God heals.

[00:25:56]So your own personal responsibility is to prevent, but in the event you get sick, the doctor will treat you >> and God will heal you. [laughter] >> Say amen.

[00:26:06]>> Say amen. Anyway, I want I want us to talk about So you're saying the environment is not friendly for private investors. So no wonder the cost goes high.

[00:26:17]And you've touched on issues to do with taxes being brought down and all that.

[00:26:21]any other thing that you think should be done to make say if I want to to open a hospital today what does that look like for me and what can be done so that I don't end up transferring this cost to the patient who walks into my facility >> my advice would be don't open a hospital that's that's [laughter] but I feel like >> here you are just killing my dream this morning it's not easyh that's what you're saying >> it's not easy I mean um um it's we are in a situation where is a business perspective >> we are a situation where you treat on credit but you pay on cash.

[00:26:54]>> All your patients are always on credit.

[00:26:56]SH patient you wait to be paid.

[00:26:58]Insurance you wait to be paid. Even the cash patients they have to pay you at the end of treatment. But you have to make sure that they have food every day.

[00:27:05]They have water every day. The place is clean. You understand? They have drugs every day. So the balance between this and that becomes very difficult for most facilities. That's why you see so many hospitals are closing down. And that's where now shortcuts come in because people have to survive. So if someone has survived, what does he do? He starts to look for shortcuts of how to make money in a way to be able to survive and to make his business.

[00:27:28]>> Also, one thing that we also have to look at as a country is how soon do we get paid? That's very important. That's reduces our cost by 20 30%. If I'm sure that I'm going to get all my claims within a month, I don't have to borrow.

[00:27:42]It means I'm able to provide a service faster. I'm able to pay my my suppliers easier. I'm able to back again.

[00:27:48]Sometimes you can't even bgain suppliers because you know you're not going to pay them on time.

[00:27:52]>> So if someone tells you I'm going to charge you 100,000 for this, you just accept because if it's going back again to 85, he's going to tell you but you're paying me after 6 months.

[00:28:00]>> If it was cash, you >> was cash you'll pay 85,000 and the cost will. So there are many financial things that has to be done at the background to make healthcare affordable. actually feel like healthcare has become a cost issue in this country. It's not a matter of we have all the ideas, we have all the papers about prevention, we have what we need to do as a country, but the cost part of it is where we have not worked on.

[00:28:23]>> There's health care access and there's access to quality health care. People would argue that those are two different things and what many Kenyans who cannot afford get is just health care for the sake of healthare. Yeah, let's talk about that a bit. I think it still boils down to the fact that you need to attract investment in that area. You need to attract for people to be able to provide healthcare, you have to attract investment in that area. How do you do that? We all know about private public partnership. Right now, for example, Mandera, they need maybe an MRI. If it was making sense, many business people will say, "Let me invest in an MRI in Mandera." That solves for you the problem there.

[00:29:05]>> Yeah. But because of the situation and how it looks, no one wants to do that.

[00:29:09]You understand? So you have like in this country for example, you only have two or three PET scans in this time and age when you have two or three PET scans. If you look at the cues, the number of patients who want to do just a PET scan, >> we're talking about thousands of people queuing up to do a PET scan, then how you going to provide quality healthcare when you people have to wait a thousand people for them to get screened or to get scanned? It's not possible. So the things that we're discussing here the quality depends on how the environment is. If the environment in is not favorable then there'll be no quality healthare because what are we going to do? Most people are going to invest in other countries. People are going to take their investment elsewhere. You're not going to have big hospitals from India, from Turkey, from China, from the US coming to establish branches here because they don't feel like the environment is going to be okay. You've seen many fund managers come here and buy hospitals and exit because they owed 600 million by insurance companies and and the government and SH so they're not able to invest. So we need to attract investment in that area to bridge the gap. Once you have that then competition becomes tight >> and then now people discuss about quality because if the competition is tight my best bet is to provide quality and a better service and then that translates into better service for Kenyans. So it has to go back to the cost conversation. How do we make the environment for healthcare better for investors?

[00:30:26]>> All right. Thank you, Albert. Your final thoughts.

[00:30:30]>> My final thoughts is that I think that we in the right direction as a country when it comes to healthcare. We are having conversations. We are discussing what we need to do. The other day I was called for a meeting with our branch for um uh social healthcare and they're listening to us. We had we've had our our lobby groups that we have our federations discuss more about health and seeing where we are going. I've seen most Kenyans right now are more concerned about health. They're trying to have the conversion which helps us because they're talking on our behalf.

[00:30:56]They're telling us what do we need to do for us. We have multiple insurance companies right now that provide good healthcare schemes for Kenyans. So my urge for Kenyans is just put these things to practice. Try to get an insurance pay. Do the prevention part of it. Get the screening when it's necessary. Do the vaccination. Visit your doctor when you can and then everything will be okay.

[00:31:17]>> Interesting. really insisted on prevention as a way of reducing the cost of health care. That's an interesting uh you know angle to look at it because that is where it starts. If we have more people not getting sick then our hospitals will not be flooded and then the bills that we are afraid of will not be coming. That's also a good way and also talking about what the government needs to do to make the environment friendlier for investors and also also helping to cut cost for the patients themselves when it comes to insurance.

[00:31:46]Albert Mandela is a healthcare investment entrepreneur, the CEO of Luton Medical Hospital. He has been talking about uh you know what the country needs to do to lower the cost of healthcare and we appreciate your time and company as well. You who woke up with us when we were starting the program until now. We do not take that for granted. Keep watching Citizen TV and enjoy the rest of your viewing.

[00:32:14]>> [music] >> Heat. Heat.