Nairobi — To Charles Kerich, the chief executive officer of the National Hospital Insurance Fund, the ultimate benefits that Kenyans will get from the cover justify the higher price they have to pay for it.

Under the new arrangement that comes into effect on September 1, contributors to NHIF will no longer have to bear the punitive expenses of dialysis for kidney patients, transplants and other major surgeries.

The cover also opens the door for outpatient services, while those who cannot afford the facility under the indigents' category are covered.

The insurer says the scheme is in line with Kenya's Vision 2030 on health and the attainment of the Millennium Development Goals on maternal health as well as child mortality.

"It is not expensive; this is value for money," says Mr Kerich. "Diseases change; those that needed admission in the past are now outpatient cases."

He gives the example of tuberculosis where previously patients were kept in a secluded ward for six months, but are now treated on outpatient basis.

However, the new rates have caused an uproar that has seen the Central Organisation of Trade Unions block the move.

Under the new rates, contributors earning up to Ksh5,999 ($74.7) a month will pay a flat rate of Ksh150 ($1.86), up from between Ksh30 ($0.37) and Ksh120 ($1.49).

At the top of the rung are those earning Ksh15,000 ($186.7) and above, who will be required to cough up between Ksh600 ($7.47) and Ksh2,000 ($24.9).

"That is tantamount to robbery. You cannot deduct one's salary without prior notice," Cotu secretary general Francis Atwoli said. Mr Atwoli argued that this contravenes local laws as well as fundamental principles of the International Labour Organisation Convention.

Like Cotu, the Federation of Kenyan Employers contends they were not consulted in the process that gave birth to the review."Reforms in the health sector cannot be implemented without adequate consultation with concerned parties," FKE chairman Patrick Obath told a past press conference.

While some medical insurance providers are opposed to the move, others say it will boost the medical insurance market.

Atia Yahya, of General Accidents Insurance describes it as "a big joke" and warns that it might not succeed in the long run.

She says no contributor or employer will be willing to pay for medical insurance twice.

"The private sector will definitely lose a category of people who will have to choose one of the two," Ms Yahya says.

She adds that the new rates were hurriedly effected while the process by which the figures were arrived at is unclear; and that NHIF lacks the capacity to implement it."NHIF cannot handle the increased income through its manual systems - which opens doors to fraud cases," she added.

Business development manager of Alexander Forbes Healthcare, Alvin Odhiambo on the other hand says the new rates will improve the insurance market space for all Kenyans.