#OutToLunch The easiest way to regulate medical bills in private hospitals

By Denis Jjuuko

The High Court in Kampala issued orders to force government to regulate medical bills for COVID-19 patients. The worst place to be for an average Ugandan today is to be in need of an Intensive Care Unit (ICU) bed so you could see another day. It is understandable that the high court came to the side of the people in need of ICU and High Dependency Unit (HDU) beds but it is the wrong thing.

Uganda subscribes to the liberal economy theory where everyone charges what they want. Demand and supply determine how much people charge. In early June when many people were dying and as Ugandans looked for anything that could help them survive COVID-19, lemons, and I mean lemons, went from Shs100 in some markets in Kampala to Shs2000 each!

If you need a taxi in rush hours, they triple the transport fare from A to B. Each fuel station in Kampala from the same brand has a different price per a litre of petrol. In Bakuli near Mengo, a litre of petrol is cheaper by about Shs500 than in Ntinda or Bukoto.

Schools charge as exorbitant fees as medical facilities. A kid in a nursery school who is trained how to use a potty, which it already knows pays more than those at some universities. The reason is because parents are very excited when their offspring are still young. As they grow, the excitement wanes but also there are more options. Some people go to universities while others abandon school and go do other things since they are adults.

The point is that in Uganda everyone charges whatever they want whether it is medical or not. And this didn’t start with COVID-19. Pediatricians to examine a child for flue charge as much as Shs100,000 in consultancy fees!

How is the government going to regulate these fees? Cancer patients long before COVID-19 have been paying enormous bills yet the government spends USD150 million a year on average taking its officials abroad for treatment. This is enough money to set up hospitals here.

I was looking at the Kampala COVID-19 ICU/HDU Dashboard set up by the Association of Anesthesiologists of Uganda that give real time update of the availability of ICU/HDU. A hospital in one of the suburbs set up originally in a home less than 10 years ago has 17 ICU beds — the most in any private facility. How did they get them? This hospital is run by a couple who are as old as the NRM has been in power. How did they set up the facility where the government has failed?

The easiest way for the government to regulate medical bills and even school fees is by building more hospitals and schools. Most people in government today who make decisions were either born in public hospitals or at home by traditional birth attendants. The majority if not all went to public schools. Today, nobody with some little income wants to take their kids to public schools. People rather take on unbearable debt borrowing school fees to give their kids a fighting chance later in life than sending them to a school where they won’t learn much.

Uganda’s population has significantly grown over the last 30 years from 18 million to 45 million today but the public facilities such as schools and health facilities haven’t. If we had working public schools and hospitals, we won’t be running to court to regulate anything. The super wealthy would take their kids to the few expensive private schools while the majority would be fine with public schools. The same with hospitals.

The best way to regulate medical bills in private hospitals is by having effective public hospitals in adequate numbers to match the population. The private hospitals will then charge what is acceptable to stay in business. They would also improve their service to attract the super wealthy customers. The same would be for schools.

Today, we have 529 members of parliament. The argument for the proliferation of political constituencies is to serve the population. Why don’t we flip the chart and ensure that before a constituency is set up, there is a proper well managed hospital and public schools to serve the increasing population? Do people want more MPs or more hospitals and schools? The money spent on a single MP every five-year term is enough to set up a hospital and a school in that area. If we invested in such for 10 years and then bring in MPs, the MPs wouldn’t have to buy 25-year-old Toyata Supercustom vans and paint them with a cross and the word ambulance.

The writer is a communication and visibility consultant. djjuuko@gmail.com

Tags: COVID19 Treatment in Uganda, Denis Jjuuko, Mulago hospital, Out to Lunch, Private hospitals in Uganda

Out to Lunch

OutToLunch: African Union could help national airlines struggling to fly

OutToLunch: African Union could help national airlines struggling to fly By Denis Jjuuko Sometime back, the Uganda Civil Aviation Authority decided to mark an anniversary by organizing a flying activity. What one needed to do was to arrive at Entebbe airport with Shs50,000. They would then put them on a flight and fly them around Uganda. The queue stretched many miles. The guys at CBS FM also did something similar during one of their Nkuuka y’Omwaka (end of year) events. Pay some little money and they fly you around Kampala. Thousands of people lined up for this once in a lifetime opportunity. If you watch TikTok regularly, you will see many people posting their trips claiming that they “catch flights, not feelings” and all sorts of things. If there is anything many people in Africa love, it is flying even if it is flying to nowhere. Many people on the continent consider flying an element of success. I think it is linked to widespread poverty. In many countries, domestic flights are rare as there is hardly any infrastructure. Where it exists, air tickets are expensive, thereby eliminating many people from boarding flights from one town to another. Those who manage to fly are considered the lucky ones. That probably explains why many family members escort their relatives to the airport in droves. Minibuses full of people descend at airports, drumming and dancing as the traveler busks in glory. They have finally made it. Upon return, some even hold parties. Parents pray for their children to also get an opportunity to fly. If you eavesdrop at Entebbe before departure, you may hear of somebody calling a relative or friend to engage them in prayer so that they also find some luck one day to fly and I am not making this up. It is that serious. Flying to many isn’t just a means of travel. It is status. It is arrival on the big stage. It is success. That same mindset many times explains the desire by countries to set up airlines. Every country on the continent wants to set up a flag carrier. The reasons given are many. National pride is usually among the top five. Airport or aviation authorities also with the same mindset slap huge taxes on each ticket. Airport ground handling is one of the most lucrative businesses in Africa even when the number of passengers going through these airports is minimal. Passengers who have longed to fly expect five-star experiences even when they don’t want to pay for them — champagne to flow endlessly, great food, free internet, movies and the like. To keep these few passengers happy, airlines end up charging a premium, thereby eliminating many people who would have been able to fly. It then becomes difficult to make money from a very small base of regular passengers. Yet, we many times complain about the exorbitant air ticket rates forgetting that everything we consume on board comes at a price. The equipment is expensive to buy, operate and maintain. Also, the majority of Africans have no reason to travel much. Their incomes are meagre and majority are subsistence farmers without any real need to fly anywhere. Without improved incomes, African airlines will continue to struggle. Also, because poor countries love owning national flag carriers without putting in enough resources, the airlines will continue to struggle to compete with middle eastern carriers. How on earth is a national airline with global or even continental ambitions but operating just 4-6 planes going to compete with Emirates, Qatar or even Air Arabia? It is always going to be frustrations for passengers who in the era of social media who are going to create one communication crisis after another. Brand reputation tanks. The few passengers end up preferring to pay a premium to fly the reliable carriers from Middle East, Europe or even Ethiopia. The national airline ends up in the cemetery. Flying within Africa could provide a lifeline for African national carriers but many countries demand visas from each African while allowing Europeans and North Americans to fly in without them. If people need expensive visas that are also difficult to access, it then becomes very difficult to create a critical mass of travelers within the continent. Look at Europe for example, it is almost borderless. People just wake up and travel without worrying about access. Although it is a very rich continent, being borderless is one of the reasons many people fly in Europe and air tickets are very cheap. The African Union need not be an organization that issues communiques only rather one that facilitates movement and trade across the continent by removing barriers that keep us under developed. The writer is a communication and visibility consultant. djjuuko@gmail.com

March 3, 2026

Out to Lunch

#OutToLunch: Some of the big bets for 2026

By Denis Jjuuko It was just the other day when many people were making resolutions for 2025. Days turned into weeks, months and now a whole year. You blink, and it is a new year. I hope that you managed to achieve those targets you set for 2025. If you didn’t, well, you can still list them for 2026 and work on the issues that made you fail to achieve them. Well, there are so many things that are happening in 2026. An election is upon us and it comes fast—starting on 15 January. I hope that your candidate wins and most importantly that they do what they are promising to do. In the meantime, I thought of a few things that could be important in 2026. They could be business ideas or stuff that may make your life better one day. Generators, power back up As I was writing this, a close friend called me and she sounded desperate. Her electricity had failed and she was worried about spending yet another night in darkness. She had bought an inverter but because of a prolonged power shutdown in her residence area, her batteries were drained. She fears darkness. So, she thought I could be a plug for a standby generator for a night. We made frantic phone calls but many people with generators for hire had closed for the night. Anyway, it reminded me of a visit I made a few months ago to a friend’s home. I found people installing a generator. My friend had rightly predicted that the transition from one electricity distributor to another wouldn’t be that smooth and had envisaged the return to darkness. I had thought that he was panicking. He wasn’t. The new distributor has told us that electricity will stabilize in a few years. So, in 2026, either get a standby generator for your home or business or start dealing in them. Water harvesting When electricity fails, the guys at Katosi and Gaba inform us that they can’t pump water from Lake Victoria. This means that the taps soon run dry. When we were younger, we used to ask ourselves a silly question. What would should we rather have? Running water or electricity? We thought we had left those days more than 20 years ago. And it seems the question wasn’t even silly after all. So, what would you rather have in 2026? Water or electricity? Well, in 2026, either get a water tank for rain harvesting or start dealing in them. Car parts The smart guys at the Ministry of Works and Transport have declared a mandatory vehicle inspection at your cost. Not a bad thing if it would make our roads safer. But if you live in some of these parts of Kampala, most likely your car won’t pass the test. If it does, it will not be in a good shape a few days later. Some of the roads in Kampala have the biggest potholes ever seen in the world. If you drive a car that was once owned by somebody in Asia or Europe or north America and got rid of it by selling it to you, be prepared for a new suspension every few weeks. You may also have to budget for a bumper in 2026. If you live in a neighborhood with a paved road and potholes aren’t your problems, well, still budget for some body parts. However much you rivet your car, guys will still pluck off stuff in traffic jam or they will scale your fence and “undress” your car. So, in 2026, plan for car spare parts or start dealing in them. Coffee and gold Coffee and gold are most likely going to continue being top forex earners for Uganda in 2026. You may have to look for ways to get involved. Gold, though, has expensive school fees, so invest with care. Coffee, some call it the green gold, is a bit easy. Entry fees are not so exorbitant and many people have knowledge of how to grow it, trade it or drink it. If growing it is where you want to start, think of some bit of irrigation. Changes in the climate are real but also water in Uganda is easily available in many parts where coffee is grown. A few feet underground, and there is reliable water all year long. In 2026, find a way to deal in coffee, remember “it doesn’t lie” or even gold if you have the school fees. The writer is a communication and visibility consultant. djjuuko@gmail.com

January 22, 2026

Out to Lunch

#OutToLunch: How Uganda’s next president could easily reduce the housing deficit

By Denis Jjuuko It is not uncommon to find a social media post in Uganda regarding the price of land or property being shared many times. The argument is that land prices are extremely high especially around Kampala and in many major cities or towns across the country. With an ever-increasing population and poor infrastructure and services a few kilometres outside these major urban centres, it shouldn’t be entirely surprising that land is expensive. I have always given an example of Mpigi town, which is nearer to Kampala than Entebbe but a difficult place to commute due to poor infrastructure. Yet with the Entebbe expressway or even the old road, Entebbe is an easier place to access. So, land prices around Entebbe will always be high as not many people would make Mpigi their area of residence while working in Kampala. That though will change when the Kampala-Mpigi Expressway is complete. However, construction of infrastructure such as expressways in Uganda takes a very long time leading to people crowding around the urban areas where it is easier to commute to their workplaces and services such as hospitals and schools are better. This increases pressures on land for housing purposes in urban areas. And as the population grows, land, an inelastic resource becomes more expensive. Many young people end up struggling to build houses. With the current housing shortage said to be over 2.4 million units in Uganda, poor infrastructure and services and an ever increasing population, the price of land will only continue to rise unless the government does something. And that wouldn’t be nationalizing land like some people urge whenever there are delays in executing infrastructure projects or when the price of land is seen as a hindrance to young people owning houses. Government must realize that the most valuable asset the majority of Ugandans will ever own is a house. Once people own property, they wouldn’t want to create so much chaos that could lead to destruction. Empowering young people to own houses should therefore be in the government’s best interests. Since land in Uganda for housing is largely owned by private entities or communities who determine its cost without any guiding principles, government could create a land bank from which individuals could buy land or a house. How would this work? And since we are going to the polls next week, the country’s next president has his work well cut out. In urban areas like greater Kampala, government could buy large tracts of land in Mukono, Mpigi, Mityana and Luweero and demarcate it for planned housing estates similar with what private land dealers do but a bit better. Land would be divided into small pieces with architectural plans drawn by leading experts. Schools, recreation, and health facilities would be planned. The government would then sell the land at a rate lower than the private sector. Nobody would be allowed to deviate from the architectural plan. If you bought in an area with bungalow houses, you build the exact bungalow. If you bought in an area for storied villas, you build a storied villa as per the architectural plan. Each person or legally married couple would be allowed to buy only one plot and you can’t sell it to another person at any rate. If a buyer prefers to sell, he sells it back to the government at the price he bought it. This would protect the land from speculators who buy, hoard and then sell at an exorbitant price. Because the cost of building a house with a given architectural plan is easy to establish, banks would only rent a certain amount of money. Banks willing to lend the money would not give it to the individual as is usually the case, rather a prequalified construction company that can deliver the house within the established cost of building it with a capped interest rate or profit. This is how Islamic banking works and therefore not a novel idea that is difficult to implement. Should a person fail to pay, the government buys it from the bank at the set amount and then sells it to somebody else. People could pay in installments over a given period. Monthly deductions could be made to salaried workers such as civil servants interested. The government can then construct roads and expressways to those areas as many people would be living in these housing estates. Public transport, schools and health facilities would be prioritized. More young people would end up owning houses and therefore a huge stake in their country and ministry of urban planning would have something big to deliver. The price of land for housing would plummet too enabling more people to own houses. The writer is a communication and visibility consultant. djjuuko@gmail.com

January 20, 2026