Why the rising healthcare costs call for new mindset

We often think of healthcare as something we turn to when we are unwell. A service we access, a system we rely on. Yet for many Kenyan households, healthcare is something far more precarious: a financial cliff.

A single illness, an unexpected accident, a hospital bill that exceeds a household’s income. A family that was just getting by, suddenly finds itself in free fall, sacrificing school fees, skipping meals, or selling assets to survive.

The World Health Organisation (WHO) refers to this as catastrophic health expenditure, when healthcare costs exceed 10 to 25 percent of a household’s income, forcing impossible trade-offs. In Kenya, this experience is not rare.

The World Bank estimates that close to 1 million Kenyans are pushed into poverty every year due to out-of-pocket medical expenses.

Kenya’s National Health Accounts show that 24 percent of total health spending comes directly from households, which is significantly above the WHO's global benchmark of 15 percent.

A joint study by WHO and the Kemri Wellcome Trust found that 13.7 percent of households have experienced catastrophic health expenditure, with the burden falling most heavily on low-income families, the uninsured and those managing chronic illness.

These figures may appear clinical, yet behind them are very real consequences. Skipped diagnoses, delayed treatment, abandoned care, choices no family should ever have to make.

Part of the challenge is in the structure of health financing. Kenya has made good progress in policy reform and infrastructure investment. However, the financing model has not kept pace with how people live and earn.

The changing nature of illness adds to the complexity. Non-communicable diseases such as diabetes, hypertension, and cancer now dominate hospital admissions.

They require continuity, financial consistency and long-term access to care; three elements many households cannot guarantee. This is where the conversation becomes more uncomfortable.

Common solutions such as universal health coverage and public private partnerships are all important. Yet these alone don't address the deeper issue: how to design health financing that protects people from poverty without overburdening the system or each other.

The future of health financing lies in multiple overlapping strategies; micro contributions through mobile money, Sacco based pooling, flexible benefit designs that prioritise outpatient and chronic care and targeted subsidies for the most vulnerable.

Insurers in Kenya have begun to make meaningful shifts through the expansion of micro-insurance. These products, built around low premiums, simple enrolment, and mobile platforms, aim to improve accessibility for workers in the informal economy.

The growing adoption of these models reflects recognition of the protection gap and a willingness to respond. But the scale remains limited and many of the most vulnerable are still uninsured or underinsured.

A hospital bill should not be the difference between dignity and desperation. If it is, then we are not just managing a health crisis. We are presiding over the quiet unravelling of choice, progress, and human stability.

The promise is clear, but unlocking its full potential will require broader uptake, deeper affordability, and integration with long term, preventive care. Importantly, a shift in mindset is required.

It is no longer enough to measure progress by budgets, infrastructure, or enrolment numbers. The real test is simpler, yet harder: are households truly protected?

Catastrophic health expenditure is not only about the price of medicine. It reflects the cost of being unseen, unprotected, and excluded from a system that was never designed with you in mind.

There is room to build differently. Not as an ideal, but as an economic and moral imperative.

The writer is CEO, Jubilee Health Insurance