MP Amisi pushes for investment-based model in SHA health contributions debate

Saboti Constituency MP Caleb Amisi has sparked fresh debate on Kenya’s health financing system after proposing a shift from the current insurance model to an investment-based structure for mandatory health contributions, arguing that citizens should be able to see financial value grow from their monthly deductions rather than lose them into a pooled system.

Speaking during a Radio Generation interview on Wednesday, Amisi questioned the fairness and transparency of the current setup under the Social Health Authority, saying many contributors feel shortchanged when they do not directly benefit from medical services despite regular deductions.

He argued that unused contributions should not remain idle in a common pool but should instead be invested in government-backed financial instruments such as bonds and treasury bills, where they would generate returns over time for the benefit of contributors.

“I, Caleb Amisi, have been contributing to SHA. I’ve never gone to a hospital and benefited out of it, private or public, so where does that money go? And why do you condemn me to give that money?” he questioned.

Under his proposal, the Social Health Insurance Fund would function more like an investment portfolio, where monthly deductions are actively managed and allowed to grow, rather than being immediately used in risk pooling for healthcare expenses.

“It is my view that a health fund must be an investment kit. If I contribute, that money must go to an investment kit. If by 10 years I’m not sick, that money must be invested and be recouped back to me,” he said.

He further suggested that contributors should have the option to withdraw accumulated value if they remain healthy over long periods, arguing that this would make the system feel more personal and financially fair.

Amisi maintained that such a model could strengthen trust in the system, since citizens would view their deductions as savings or assets rather than lost contributions.

The lawmaker also questioned the principle of pooling funds in the current insurance design, saying it creates an imbalance where some contributors benefit more than others depending on their health status.

According to him, an investment-linked approach would also enhance national savings and provide a more stable financial base for long-term healthcare funding needs.

The Ministry of Health oversees the rollout of the Social Health Authority system, which was established under the Social Health Insurance Act, 2023, and began operations on October 1, 2024, replacing the National Hospital Insurance Fund that had existed since 1966.

SHA and SHIF were introduced to expand Universal Health Coverage, especially targeting informal workers and vulnerable households, but the system has faced questions over funding gaps, rollout challenges, and public trust in how contributions translate into benefits.

Amisi’s remarks add to the growing national conversation on whether Kenya’s health financing model should remain based on insurance risk pooling or move toward systems that offer clearer individual financial returns alongside healthcare coverage.