Transforming Health Insurance From Idea To Implementation: Dr. Abdi Shares Insights On Gazetting

Siti, remind us the day's proverb. Yes, yes, yes. And Dr. Muhammad will remind us his interpretation of that proverb which is actually very, very good. His interpretation is excellent actually. If you are told a dog had run off with your ear, would you run after the dog or first search for your ear? My you have to find out what is it that you are being told before you take an action, whether it's true or not. So you understand for yourself and then now you can ask for clarification and accept the message and the messenger or dismiss. Okay. Yes. So the new payments into SHIF, 2.75% of your gross income. Yes. Okay. Yes. So a friend of mine here called Andrew says, I will pay 10,000 shillings a month. Yes. To this SHIF thing. Yes. And yet I'll only be entitled to 950 shillings dental. Yes. Or 1,000 shillings optical. Surely. 10,000 shillings a month. Yes. 120,000 shillings premiums a year. Yes. And what I'm entitled to is 950 for dental. Okay. 1,000 for optical. So there has been a lot of issue on the issue of benefits and tariffs. So there is one thing that we need to understand. When you are designing a benefit package for a UHC program, what you look at is, what is the severity of this condition? What is the catastrophic nature of spending in terms of money that the person needs to spend on? Then what is the, what is the available resources? What is the disease burden? So that you are able to say, this is the basket that we have because this is the basket of resources that we have and this is the problems that we are facing as a country. Then what do we need to prioritize that will help people from not running into challenges? So there is someone who is paying 10,000. There is someone else who's paying 300 shillings. So these two will be in one basket which is 10,300 and now you need to provide services which is equivalent to this 10,300 and that's how you come up with the benefit and tariffs. But more importantly is for Kenyans to realize it, for the first time they can actually participate in designing that benefit and tariff because we have a Benefits and Tariffs Committee established under the regulations that has civil society representation, has provider representations, has the DG, has the ministry CS appointee, has share appointee, only one seat, has experts in health economics, has Council of Governors appointees and then allows individuals and associations and groups to petition and say we have seen this and that needs to be gazetted and the benefit and tariff to be reviewed after every two years. So there's one kind of individual missing from that group, an expert in costing. A health economist. A health economist is not necessarily an expert in costing. So you have, no there's an actuary from the Shah. Shah's representative is an actuary. He's an actuarist? Yes. Go on, then you've answered my question. Okay, so that way now you can petition and say there is a disease that you have forgotten or there is a procedure that's missing from your benefits and tariffs. So that's how we have come up with the current benefits and tariffs. To be honest, Denton was not part and parcel of NHIF benefits. Ever? Ever. It was, but for the few chosen ones. How did the few chosen ones get chosen to have their teeth represented? Because they were the so-called managed schemes and who did it belong to? It belonged to people who are currently in active employment in the three arms of government or who have retired from those three arms of government. So they were the only ones who had dental and optical. The rest of us Kenyans did not have those things. So essentially they arranged preferential treatment for themselves? Yes, they had a preferential treatment because they had what is called managed schemes. Okay. So and that's why, so that people understand when you see a lot of backlash, we said we don't want under Shah to have preferential treatment. What we want is everyone to have the same benefit and the same tariff. Let me ask the question. Yes. If you say that that 10,300 is what forms the basis on which you will provide the service. Yes. All right. The reason why people have access to other services is often a question of what they are willing to pay in addition. Yes. NHIF was at a point where they even had similar services. Yes. Their branches of government that had these managed schemes where you paid more than what other people are paying. Yes. But then you are given more services. Yes. Right? Yes. Now this committee that you mentioned that Shah has. Yes. What are they going to be considering? Are they going to be considering something similar? Because there's a basic service that everybody gets. Yes. What about if somebody wants more and they're willing to pay for it? You go to the private sector. We allow you to go to the private sector. And this committee is not for Shah. It's at a university. Based at a university. Secretarial services is provided by the Ministry of Health. You just need to look at the other regulation. Now this is what they do. That committee receives petitions. Looks at what has been in the tariff. What has been the benefits. They look at the basket. They look at and they say how how is the uptick that we have had over the last few years. So the other thing that we need to realize is what is it that we need to prioritize as a country moving forward. And that's what now that committee will be looking at and saying we have received this petition. Which diseases do we need? Yes. Which diseases is prevalent. Which is the one that's pushing people into poverty. Because I don't recall if you have ever been called for Harambee for dental procedure ever. Extractions. So you see but you have been called for someone who needs transplant. Because that is a huge burden to individual and to families. So that is the prioritization that this group will be doing. That they will say this is what we can and it's it has to be sustainable. So they will look at the amount what we have in the basket and what we can offer as a service. From your math. Yes. I never did your actuaries. Yes. What's the average highest amount that you're going to be receiving from individuals? There are of course those that are going to be on 300. Yes. Those that are going to be on 20,000 like in Andrew my friend. Yes. But where is the median? The medium is around 600. 600 shillings a month. Yes. That will be the average that we will receive from the majority of Kenyans. Because that's what is the premium that you will receive from. But what what I want us also to realize is this is the other thing that the public needs to understand. That if only people who have chronic conditions pay and the young people say I'm not interested or I am employed. You are employed formally today. You can be fired tomorrow. Retrenchment can happen easily. Today you are paying 10,000 as your premium because you have a salary. Yeah. But tomorrow you have you don't have a salary and you might be ending up paying the 400 shilling as your premium or 500 shilling as your premium. So everyone needs to pay. If I'm a dialysis patients and I pay 500 and it's 6,000 and if we are a million of us we will pay a thousand of us even. We will pay six million shilling only. A thousand of us. Six million. Do you know how much that your six thousand can't even cover one session for dialysis. Just one. And this is your annual premium. It can't cover one session. So meaning you need more people. Another 1 million people maybe to pay 300 or 6,000 each. Then you have a basket now that can say okay we cover the person who is suffering from kidney conditions. Right. And we cover the person who needs surgery. Right. And we cover the person who has cancer because those are those are catastrophic expenditure diseases and very costly. Why is SHIF paying for chronic conditions? Why is SHIF paying for chronic? That is the one. Why would SHIF be paying for chronic? I thought we have three funds that I share. Yes. One of those funds is the Chronic Critical and Emergency Care Fund. Yes. Which is exchequer funded. Yes. Not coming from SHIF. And now this is where now Kenyans need to help us in terms of resource allocations. So the Emergency Chronic Critical Index Fund was not meant to be the first payer. So you have contributed. You have done your two or three dialysis sessions. You need extra session. Now the chronic comes in. You have undergone radiotherapy, four sessions. You have exhausted from your basket of SHIF. Now you need extra. Previously what was happening is you are supposed to go back to your pocket. The reason why we have set up the exchequer funded Chronic Critical Illness Fund is now this one steps in and says Eric has exhausted his chronic disease treatment but the disease is not yet over or the treatment is not yet over. He needs few more sessions or few more interventions and that's where now the Chronic Critical Illness was supposed to step in. So for this current budget we haven't been allocated enough. How much do you need? For this one we can take up as much as possible. Even a hundred two hundred billion because you don't want to limit people's extra because in terms of diseases you don't know. Yes. So but the estimated amount was around 80 billion. Is there a place or a space in which biometric systems feature in this this rollout that we are speaking of? Thank you. I wanted to address I had already even written it. So there's no place for biometrics in the current system. If you are an adult and you have a national ID you will use your biometrics that you have given during your registration for your ID. That's what now the system pulls. That you all you need is you just say this is my national ID whatever number it is and the system will be able to pick that from NRB the National Registration Bureau. So the people who will need ID biometrics are dependents who are above 7 and 18 in between. But for now once you declare them as your dependents OTP is enough. So for adults you don't need biometrics. Okay. We have that's why we have one single source of truth. Eric does not become CT overnight because he has given his fingerprints in another system in another database. So that you don't have many databases with different fingerprints. We just have one. We identify CT because CT has given his biometrics long time ago. But I tell you we do already have the problem that you've just mentioned we don't have. Yes. If you're in my Asian number it's a new set of fingerprints blah blah blah blah blah. If you're in who do my number it's a new set of blah blah blah blah blah blah. If you have the old ID which I have you have it blah blah blah blah blah. Now chef comes along and says it is unified it is one. I'm going somewhere with this. Part of the problems that we are talking about and it's problems with systems. We say that NHL had a certain system. Okay. People have been trained in it. Shaz come with another system. Okay. People have been trained in it. I assume. Okay. Now is that reference to the transfer of data from one system to another. Why is this? Why am I raising this issue? Because one of the things we keep dealing with in this country is the employment of spirits. They are called ghost workers. And they exist. And part of the problem that NHL seem to have is the same problem that education system has. Money is deployed to institutions that don't exist. Students who don't exist. NHL patients who don't exist. Ailments which don't exist. So the moment you have multiple sources of identification that problem doesn't seem like it's going to come to an end soon. And if you have listened to me carefully I said we will use the National Reference Bureau data. So you city is only city. There's no other city. This is the one with registering your ID. Yes. The National Registration Bureau. Yes. So so that way we don't have many other databases. We are using one database. We are not creating our database. And we are and we are telling you to use your ID as your identifier. I'm not giving you a share number. I'm just telling you use just declare your number and say my ID number is 1 0 2 2. That's it. That's it. Yes. Even when you are registering. That's what you register with. Because when you go to the registration portal it just tells you ID and your data comes up. If you have tried. Try. You will see. You say your ID number it tells you you are so and so so and so so and so from this village from this town from this. Your data as it was. Let's go to the phone lines because we had promised that we're going to let people speak to you. 0 7 1 9 0 1 2 600. That's the number. Okay. 0 7 1 9 0 1 2 600. Let's go to the phone lines. Let's hear this. Good morning. Hello. Hello. Good morning. Morning to you. How are you doing? My name I'm fine. Thank you. What's your name? My name is Dr. Darwin. Go ahead. Ask your question. Thank you. I have a few comments. I've been listening to Dr. Mohammed Abdi, the chairman, my fellow colleague and most of us in health care actually are opposing shift. We are not pro-shift because of the sequence in which it has been laid down. First, talk about NHIF which was established in 1966 and has grown over time. NHIF has grown to cover mothers, that is the Linda Mama. It has gone to cover school-going children as the Edwarphia. It had expanded its wings to kidney, renal transplant and dialysis and we felt it was a fairly working system. Now when shift was being brought in, it would have instead just looked like a merger. Why? One, it creates a very new system. If you look at how the shift was being set up, there are three funds actually. There's the primary health care fund, there's an emergency and chronic illness fund and the social health insurance fund and the first two funds they are being catered for from the exchequer. Now the 2.75 of our growth is going to run the social health insurance fund. We got a problem with the tendering system of this fund. It was from single-source tendering system and we've seen a lot of information including a company called Apiero. Apiero is being run by one Gatabaki Judy who's related to one of the people who are known in government. Dr. Mbuka, sorry to interrupt you. You're going round now. So the main issue here, the main thrust of your issue is that you are opposed to this because of opacity in the process. No, we're opposed to this because of the tendering system. Government institutions are supposed to have, it's supposed to be a national tendering system, not a single-source tendering system. That is one. All right, let's take that one Dr. Mbuka because we have other callers on the line. Gregory Nairobi, good morning. Morning, how are you? Very well. I'm currently working in Mukurukuwa, Ruben. Okay. The informal settlement to the marginalized people. I have two questions for Dr. Ari here. How are the marginalized going to afford the payment for the poor? I mean, without a source of income, how are they going to afford this healthcare? Number two, is it an insurance fund or a social payment scheme? I mean, from my understanding of insurance, it's that you pay less to get more. But from this, it's like we're removing more money to get less. And the last one is, is there a five-year budget plan, like after this, I mean, regime is out, what is the sustainability of the healthcare program? Thank you. Thank you very much, Gregory. Mbuka Nairobi, hello. Ignandi, Mbuka. Hello, sir. Hello. Yes, mine will be just very quick. Go ahead. I want to ask Dr. Ari one question. When he was introducing his talk, he talked about fake news on this social health insurance fund. Now, what mechanism does the Ministry have to counter this fake news? Have they partnered with the media houses so that this kind of fake news can be can be done away with? Now, another one is this kind of share. If I go to hospital, will I walk in and walk out without being asked any pay, the way some other insurance covers are doing? Thank you. Number three, what are they going to do with the retirees once they are out of the work? Will they transition them also to their retirement, whatever benefits, so that they don't get confused with this issue? Thank you very much. Thank you very much. MOC Nairobi, hello. Yes, good morning. Morning. Now, I have three questions. First is to tell the chair, the fake news normally comes as a result of lack of news. So, when there is lack of news, then there is fake news. The problem we have in Kenya is always rushing. Even with the things which might be important, people always rush. I don't know what the interest. Now, my question is, we've talked about the poor. Initially, NHF used to pay the installment, the 500 per month. Now, this one, the fake news, I don't know if it is fake news or it is the right news, you will be paying up front. If you're paying 3,000, 300, at the beginning of the year, you pay 3600. Now, is it affordable to the poor? The second thing, I feel there is a fairness in contribution, that is okay, but in terms of benefits, there is no fairness. People are really struggling. Now, the dental optical, the initial NHF, we never used to have them. We were paying less. Now that we are paying more, especially the employed, why are we still being punished by being given less? The last time I also attended a sensation forum by their members, the talk of Linda Mama, and this thing was covering level one and level two, that is free, but now when you go to deliver, which is most likely level four and above, or level three and above, you have to be a fully paid up member. So are these pregnant women aware that as long as they go for the clinic, they also need to pay so that they can deliver? If it is a fake news, maybe you can clarify. Thank you. If it is not, then I think you also need to know. Thank you. Victor Nyerobi, before the doctor answers to these questions. Yes, good morning. Good morning, Victor. Yes, the other day I was in Nigori, my home country, Nigori. There is a place called Kademo. I was asking around because I'm a special care giver, ambulance operation and others. So I was just doing my rough sampling on how much people know about the shift and all these things around shops. You can tell that most people don't know about this. And because I'm in an ambulance operation system, people are asking like, we've heard about Terikali Nalipa, layman's perception that Terikali Nalipa I normally find a rough time in this thing, but that's as bad because even in France, you don't have a clear answer. So can you, as a doctor in your position, make it clear on a primary emergency and all that? How does it work? All right. I think we can even start with that. Right. Just explain, how do those three funds work? When I go to a level one, level two facility, do I go back home free, not paying a thing? Thank you. So the three funds, the primary health care fund, the social health insurance fund, and the emergency chronic critical illness fund. So primary health care fund is tax funded. It's free. That is the one that comes from Treasury. You can access it in level two, three, and selected level fours. Selected level fours, one of them could be Loi Tok Tok, sub-county hospital, because there is no health center dispensary nearby in that town. So that's how we do the selected level fours. So for that one, you don't need to, all you need to do is register to begin with. Just register. Star 147? Yes, for Shah. Okay. Then you are entitled to that access. And registration means pay? No. You don't need to pay? Yes. Okay. Yes. You just register to begin with. Okay. And do your proximity testing. Then now, for you to benefit from higher services in level four, five, six, then you have to go to, if you are unemployed, do your proximity testing, you pay your premium, then now you have moved to the social health insurance fund. There, you have paid a premium. Then now you have access to those services. Okay. The third one is emergency chronic critical illness. So emergency is free whether you have registered or not registered. So that one you don't need any form of even registration, because it's an emergency. There's no time to tell you register when you are bleeding. Yeah. So that one is automatic. You go to any health facility? Yes. If it's an accident, you may be taken to the nearest facility which will be in level five. Any, any, any, any for emergency. The chronic critical illness fund was supposed to address the issues when you have exhausted your tariffs at shift level. Now you continuously need services because you have done your part in terms of your disease is not yet cured and you need to benefit. Then now you move in, it steps in and reduces the burden. That was the idea and it's also tax funded as well. For emergency, it has been in the constitution from 2010, never implemented. It was in the... You were never supposed to be turned away? Yes. It used to be never to be turned away by word of mouth. But now here we are, we are saying Shah is taking up that responsibility to say, we will settle that bill to the provider. So that is the thing. Somebody then just on the same line, I think Amos is asking about the expectant mothers. Yes. So you're going for clinic at Kimana Dispensary? Yes. And then when it comes to delivery? Yes. You go to Loy Tok Tok? Yes. Level four? Yes. At Kimana you went home. Loy Tok Tok, now they say this is a level four and it's a referral. So it's if Loy Tok Tok is select level four hospital, then you don't need to pay because it's part of the primary health care. So your delivery is covered. And remember, I would say 60 to 70% of deliveries occur in level two and three facilities. At the dispensary? Yes. And the health center level. So what's the issue of, now let me go back to the each of the people. So in this one what we are saying. Yes, you are not paid. If you go to a health center or dispensary. For delivery. For delivery. All you need is to have registered. All you need is to have registered. That's it. And this is with reference to government public hospitals? Even private and mission hospitals that have signed the contract for level two. And how will the citizens know which have signed? Ahead of time. Ahead of time. Yes, you need to know. Yes. When you go for prenatal clinics. Yes. You can ask the facility. Are you part of the SHAR? Okay. Now, now you will advise me. No. On how you want. Other than saying SHAR accredited facility. Yes. I don't know how else we they will be able to communicate. That communication department that I mentioned. Yes. Exactly is their job. Because you are talking about 47 counties. You need to know. Yes. Yes. I am in Wajir. I am in Turkana. I am in Samburu. Yes. I am in Marisabet. Yes. I'm in Tanariva. Yes. Which hospital? The government hospitals are known. Public hospitals are known. Which private hospital have you signed up with that I can go to? So there are even as it is. It is that communication that I'm talking about. Yes. Okay. So that it is known. If it is budgeted for let the public know where they can go ahead of time. So there there are a few ways to do that. One is the toll-free number which will be able to guide you in your locality which facility is on the panel contracted. The second one is the facility to display and say they are accredited. Then the third way is your branch should be able to tell you if you walk to your nearest branch or Huduma Center. But I'm not I'm not I'm not no no no I I fully understand your city because I'm not a communication expert. No no you're not but yes imagine a situation when people are asked to public participate as they were on Friday. Yes. And they were told you need all you need to do is look at the Gazette notice on this on this date. Yes. It will tell you where it is that you actually supposed to go to public participate or look at our website. Look at the parliamentary website and determine from the website depending on the county that you're from where it is. I think you've understood my point. And we have those two. It needs to be communicated effectively. Okay. Whether it is radio. Whether it is newspapers. Yes. Local. Local. So that no one can say they have not been told. Okay. I get you and I think this is a challenge that I will take back to the communication department. They need to up their game when it comes to the issue of communication. I can't be a jack of all trades so I don't know what they need. If it was a medical side I would have given a clear explanation. Darwin was trying to explain the three funds. Yes. But it seems he hasn't understood. He just needs to go back and read the documents for him to know what they are and how they interface. Yes we will not have managed schemes and we just want that to be very clear and that will be in line with answering the question of Amos. Fairness in contribution and fairness in benefits. Because previously NHIF had all members who are equal but some were more equal than the others. That is the kind of thing that we don't want to have. What we wanted is to have fair in contribution. Fairness in contribution and the reason why we need fairness in contribution is if you earn a million and you are paying a thousand seven hundred and someone else earns five thousand and they pay five hundred that is ten percent vis-a-vis 0.017 percent and you know one shilling to a person who earns little is more valuable than the person who earns a million. They cannot be related. Fairness in benefits that is equality. You get all equal benefits so there is no one who gets extra because they are paying extra and that is the thing that we need to be aware of. Gregory talked about the issue of marginalized. Yes. So once you register and you do your means testing it will identify you as an indigent. How is this means testing done? Remember we have a means testing problem at the university funding site. No this one is better. This one is the one where the education will come to learn from. I assure you because we have looked at the data. We have piloted. We have tested it in eight counties. We have gone to the marginalized households at that level. Looked at the model. Tested it and come up with this means testing. So it's not. So what questions are you asked for you to do? Simple questions. What kind of house do you live? What do you do? Unemployed or self-employed? Where do you stay? Locality? Married? Children? Household? Where do you live? Do you own the house? What else do you own in terms of? Is it ten acres? Do you have livestock? Do you have electronics? Do you have cars? So you answer all those questions and then finally it will give you a premium that you need to pay. So it also identifies you as an indigent. So it says Abdi is poor and the amount is 50 shilling. So that's someone who can't afford the minimum premium of 300. So this one is the person now who is identified as indigent and the other ones were supposed to be paid for by the National Government. But there are others who have been identified by the Ministry of Social Protection. The one for Waze. Yes. It's called the Inuwa Jamii. Inuwa Jamii. So the people in Inuwa Jamii automatically will be moved to Shah and will be given the beneficiary paid for by the Ministry of Social Protection. So those ones, they don't have an issue. So it's these other ones who are unemployed, never identified as indigent by anyone. Those are now the ones who will be identified through the proxy means testing. How are you getting the information from the State Department for Social Protection into this one? No, they are giving us the list. So they will say these are the people and these are the people we are paying for. Have you received the list? Yes, yes. Actually, it's not supposed to be physical received. It's API. We connect into their system and the data is migrated automatically to the database of Shah that says these are the people we are paying for and this is the process. Similar to the people who are paid for by governors or MPs. So they will list and say these are the people. But you know those ones now because they are not indigent as such. It's people now who are under social protection from the governor. Then they will register similar process, calculate their premium, then the governor or whoever is paying will pay. So the issue of insurance is you said pay less and pay more more benefits. It's not. The way this social health insurance works is everyone pays to their ability. There's no round figure to say this is the universal figure that we are paying for. You are paying according to your ability and then we put that together and then we give you benefits based on availability of resources. So it's not a matter of demanding because I have paid more, I need more or I have paid less because what will happen is the person who pays 3600, if you go to the private market and you say private insurance, they say that they can do last expense only for this one, no medical. So you can imagine if that was the route that we had taken. So it is for that reason that we are saying people need to pay according to their ability and get equality in terms of benefit. Sustainability depends on and this is the reason why our benefits are not superfluous like humongous to say we can do this, we will give you this. No, we are able to rationalize and say this is what we have in terms of resources and this is what we can offer. If we need to offer more, we need more money and that's how we have justified and that's why we have also removed the issue of managed schemes because they were draining the basket. They contribute one chili, they consume three. And the other two are contributed by others. By others. Okay. And the sustainability becomes a big challenge. Let's take two more calls before we conclude. The first one is Mohai Nairobi. Mohai, good morning. Good morning. How are you? I'm good. Please ask the question. One thing that is very surprising to me is that we are discussing SHA as if it's a noble social program. Let me just help those who are listening here. Zoom out for a bit and look at this thing critically. We are discussing a scam. I'm going to repeat that again. We are discussing a scam. Okay. Elaborate your point. You've got a minute, Mohai. I don't even know where to begin. I don't know where to begin, honestly. Do you have a question? No, it's not a question. I'm just putting it out there so that people get a clear picture of what is happening. What makes it a scam? The whole thing. There's no part of it that is here to benefit anybody. Maybe those who cooked it up. As in, for me, it's preposterous. I don't believe what I'm listening or hearing. Okay, Mohai. Let's hear from Samuel Moriri. Samuel Moriri, good morning. Good morning, Eric. Good morning. Should you ask the question, please? Okay. Mine is for that, the mean state. They have said they have piloted and does what and whatever. But why do they not use the KNBS report? You are just from census like two or three years ago. Why do they not use that? Because it was a real deal. We were told to go home, so you are counted and they saw whatever is in our homes. Then if they say, for example, they say, they ask questions. I've tried registering to that. They ask the question, do you live in a stone-walled house or something or so? What if that person is hosted? That's not his home. There are many people who are hosted outside. Then you are 18 and above and maybe you have no work. And they give you a quotation of maybe 1800. Why do they expect you to come with that kind of amount? Then the other thing, to some other civil servants and companies, they use the private insurance. What about them? Are they still linked to NHIF? Is it a compulsory? Why should it be then a compulsory? And if it's not compulsory, then how, what about the private insurance? And today, yeah, I know. That's all you can, you can respond to that because you're running out of time. Okay. So respond to that one by Samuel. Thank you. We have used the data for KNBS. And this is the other thing that people need to realize. What we have done is that database is our baseline. So the reason why we have gone back to 18 counties is to test it. And more so, the lower socioeconomic status and see, does it really reflect on the reality? Because you see, you can have a national survey, but you also need to go and try and see, does it really work at that level? So that you validate and say yes, or you need to tweak a little bit more and make it better than what is available. So for me, I would say that's the reason why, and that's why I was telling you, the education will come and learn from us. Because just taking global data alone will not be helpful. But you need to go back and see and test it. Pilot, as Siti says, to the ground, to individual households and find out what you get on this other end. Is it the reality as you are seeing it? Final thing, Dr. Terry, as we close the show, in about 30 seconds, many of the people who are commenting, even on our live stream as you can see it on social media, many of them are saying, there are so many people who just don't believe this thing. They don't understand it, they just don't believe it, they're just seeing red flags everywhere. What do you say to them as the chairman of SHAR? I think what we need to do is do a lot of more communication and education, actually. Not even communication, because people need to understand and they need to realize that for the first time there are benefits that you get without even paying a premium in this. So you are moving away from a space where you had to be a member, a paid up, for you to benefit. And even previously you had to have paid for two months waiting period for you to get a benefit. But for SHAR we are saying you pay today, you access benefits today. Immediately. So you see, those are the things that people are not yet understood. So it will take time to create this awareness. Please do, it's important. Thank you for joining us today. Dr Mohamed Abdi is the chairman of the Social Health Authority. He's been our guest for the last two hours. We'll have him again with more questions from you. This is The Situation Room. The only way to start your day.