Nairobi — The National Social Health Insurance Scheme is scheduled for another appearance at the Cabinet soon, with the private sector in the dark over its content and design.

By keeping such important information away from the public, Medical Services Minister Prof Anyang' Nyong'o has effectively told them that their opinions do not matter, and debate is irrelevant. Why the secrecy over a matter of such crucial interest to business, the health sector, and the people of Kenya?

Business loathes uncertainty. Business people will delay their decisions awaiting further information, or simply contract on the strength of plausible rumours.

The Kenya Healthcare Federation, under the auspices of the Kenya Private Sector Alliance, has made itself available for discussions to ensure that any new efforts to introduce social health insurance are done in such a way that the economy and employment do not suffer, that corruption is minimised, that the proposed scheme is efficient and sustainable, and that the public's right to choose is respected. A private sector social health insurance proposal has been forwarded to the minister but he has not given a response of any kind.

In a recession, leaders talk of cutting taxes, not increasing them. Reducing the public's disposable income in hard times will deepen Kenya's problems and that of the average Kenyan, already suffering under the weight of skyrocketing costs of food and fuel.

Additional costs will reduce employment and production, already under threat from a worldwide recession. The private sector social insurance proposal improves and rationalises benefits to Kenyans without increasing contributions. Can we at least discuss it?

WORD HAS IT THAT THE ministry plans to use the existing NHIF Act of 1998 to increase workers' contributions to facilitate an expansion of the NHIF. In 1998, the private sector was a vocal critic of the provisions of the Act that authorised its appointed board to increase contributions "from time to time."

By virtue of their mandatory nature, NHIF contributions are a tax, and the provisions of the 1998 Act are therefore blatantly unconstitutional.

Kenyans have an elected Parliament mandated to tax after debate and under public scrutiny. The ministry is opening a can of worms and adding to economic uncertainty if it seeks to bypass parliament. Can the minister tell us this is false and save us from a needless legal battle?

AMONG THE EXPECTATIONS of the private sector was that, before introducing social health insurance, the ministry should put its own house in order.

The recent sacking of the board of Kenya medical Supplies Agency for corruption and mismanagement is a good thing, but what steps have been taken to ensure the next board does not engage in the same misdeeds?

The current shortage of vaccines and Artemesin-based anti-malarials in several parts of the country does not inspire confidence that a scheme heavily based on government health services will be effective.

The ministry's website, which was to signal its interest and involvement in improved services through information technology, is void of information on its current activities, and apparently has not been significantly updated since 2006.

Clearly, IT cannot only improve the dissemination of important information on health and thus positively impact timely decision making, but can even let the public know where its billions of shillings are going.

AT THE BEGINNING OF HIS term, the minister gave every indication to the private sector that issues like confusion and illegal activities among various professional boards under the ministry would be addressed through a vigorous health sector reform secretariat.

With that in mind, many of us expected that at the very least, the defunct Central Board of Health, mandated under the Public Health Act, would be revived to control the rogue boards.

Nothing has been done. Is it too much to expect that Acts of Parliament are enforced, particularly when it is an urgent matter in the health and medical services sector?

Vision 2030 will not succeed in this climate of uncertainty. We need to know the rules of the game. We need to know if our taxes are being wasted and resources misappropriated. We need public debate on priorities, and we need a rational regulatory environment.

Diana Patel is the managing director, Avenue Healthcare