KenyanHour

The teachers’ medical service scheme, which has now become a source of numerous complaints over poor services, has run for 10 years.

Who is Jayesh Saini?

• Was the mastermind of Clinix scandal in Kenya’s healthcare history that stumbled NHIF
• Was the mastermind behind the illegal importation of Sputnik-V covid19 vaccine from Russia.
• TSC-AON Minet scandal mastermind

Jayesh-sputnik- Nairobi west hospital link

A botched deal to supply 1 million Sputnik V doses to Kenya was part of the same controversial Emirati scheme which saw an Abu Dhabi-based company with royal connections ink deals to resell Russia’s flagship covid vaccine at huge mark-ups.
Documents obtained by The Moscow Times confirmed that Russia named Aurugulf Health Investments – a firm registered in the UAE and linked to Emirati royalty – as an official Sputnik V reseller in Kenya, where it secured a contract with private healthcare company Dinlas Pharma to ship at least 1 million jabs to the African country.

Dinlas Pharma also paid significantly more than Russia’s advertised price for Sputnik V to obtain the jabs via Aurugulf. According to a pricing schedule obtained by The Moscow Times, Dinlas paid $18.50 a dose for the vaccines — almost twice Russia’s factory price of $9.95 – and planned to sell them to clients in Kenya for $42 each.
This shows the deep political ties this guy has On top of his well orchestrated game, he is the bulldoser clearly, he as well owns Medical Administration Kenya Ltd (MAKL) thru’ proxies —responsible for sorting out insurance claims for private hospitals.

How MAKL Intentionally Frustrate the insured-Teachers, Police officers, Prison officers.

For the record, MAKL is a private company and that the procurement of insurance for TSC is disguised as an insurance scheme.

The scheme tendering entity for TSC is Minet Kenya and for police is a consortium of insurance companies led by CIC General Insurance Limited.

The two insurance companies then contracted MAKL which charges up to 7 percent in administration fees to the tender amount as capitation administrator.

The premiums as provided by the government are paid directly by the procuring entities- TSC, NPSC- to Minet Kenya and CIC General Insurance Limited.

The funds are then channeled by the insurance companies to MAKL for capitation purposes, which then empanels hospitals and doctors that are then tied up as a network of hospitals to provide services for the scheme.

The suffering of the insured under the schemes starts when MAKL, which retains all the rights for admission, negotiates with hospitals to provide the services usually at very low capitation fees for patients as it aims to maximise profits over service delivery.

The hospitals also need to make profits from the low capitation fees from MAKL.

In the end the hospitals contracted by MAKL maximise profits by way of either outright denial of services or endless frustrations like being kept waiting for hours so that patients give up and opt to pay for treatment from their pockets in other health facilities or in the very same facilities which are owned by Jayesh Saini; Nairobi West hospital, Bliss medical.

For example, surgery, which requires immediate medical intervention, takes days “until one gives up for out-of-pocket financing elsewhere or dies while still waiting to be treated.”

The fewer the patients a hospital under MAKL treats, the more money it makes from the capitation fees.

MAKL and Bliss are the capitation providers and administrators for the teachers, police and prison medical insurance schemes. In the current financial year, the premium allocated by the government to the TSC for the teachers’ medical insurance cover is Sh17.9 billion, meaning that for the past nine years it has been in operation, Sh161.1 billion is what the government has paid for the teachers’ scheme.

The police and prison officers, on the other hand, have spent Sh15 billion on their medical scheme. What has concerned the Senate is that MAKL is a private company and that the procurement of insurance for TSC is disguised as an insurance scheme.

So, when Nairobi west hospital plays victim of being owed by MAKL and forces Teachers and Police officers to pay from own pockets, know the trick. It’s business and it is their business to maximize cash profit, capitation over service delivery.