The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has accused insurance companies of colluding with cartels to frustrate doctors and deny Kenyans access to quality healthcare.
In a statement released on Tuesday, August 19, the union claimed insurers were acting as gatekeepers between doctors and their patients, dictating which hospitals Kenyans can visit, the specialists they can consult, and the tests or medicines they are allowed to receive.
KMPDU Secretary General Dr. Davji Atellah said this interference undermines professional judgment, restricts patients’ options, and weakens already struggling health facilities.
“Insurance cartels are standing between doctors and their patients, denying Kenyans quality healthcare,” the union said.
The doctors further accused insurers of deliberately delaying claim settlements, a move that forces patients to pay cash or makes hospitals absorb costs. In some cases, facilities under the Social Health Authority (SHA) were allegedly asked to pay upfront before reimbursement, a move KMPDU says cripples Universal Health Coverage (UHC).
The union also raised alarm over insurers increasing patient premiums while at the same time capping what doctors and hospitals can charge. According to KMPDU, this has left healthcare workers overburdened and patients unable to access adequate treatment.
The union went on to blame regulators, including the Insurance Regulatory Authority (IRA) and the Competition Authority of Kenya (CAK), for failing to act.
“Big insurance companies are blackmailing healthcare providers, and regulators have failed to act,” the statement read.
KMPDU announced plans to release a “List of Shame” naming companies it accuses of exploiting Kenyans and frustrating healthcare providers. The union said this would help citizens make informed decisions when choosing medical cover.
Concerns around abuse of the healthcare system have also surfaced since the rollout of SHA. Earlier this month, Health CS Aden Duale suspended over 40 health facilities from the program over alleged fraud, insisting they would only be reinstated after complying with SHA rules.
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