#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: Favourable interest rates are good for everyone, not just government, banks must do more to curb digital financial crimes

#OutToLunch: Police, banks must do more to curb digital financial crimes By Denis Jjuuko A friend was recently riding on a boda boda in a leafy Kampala suburb when another speeding boda boda approached her. The approaching boda boda had a passenger, a young man, who grabbed her bag and sped off. It was in the early afternoon. It is a normal thing in Kampala to lose your bag or be attacked like that whether you are in one of Kampala’s exclusive suburbs or not. Walking on Kampala’s streets including the busiest ones is never safe. You simply don’t know when you will be attacked. Although she had some money and other essentials in her bag, her biggest concern was her smartphone. Like many people, a phone is one of those things that are hard to do without nowadays. She was frustrated and went on a frantic search for it. Reporting to the police and such other things. She can’t work without a phone so she decided to replace it as soon as possible so she can carry on with her business and be able to get in touch with her family and friends. As soon she got a replacement phone that afternoon, she started receiving several messages that scared her. The thieves who stole her phone were not ordinary ones or at least they have a network of sophisticated hackers. The messages she was now receiving indicated that money had been transferred from her bank account to another account within the same bank. This happened within a few hours or minutes of losing her phone. She hasn’t yet been able to trace the thieves and find way to get her money back. She most likely won’t succeed. Like most people who buy high end smartphones, she had thought it was one of those safe things and it couldn’t be easily cracked open in Kampala shortly after losing it. It seems the more technologically advanced smartphones become, the more sophisticated the hackers become too. There must be a racket in Kampala who send young men on boda bodas to grab smartphones so they can hack them and transfer money to their accounts within a few minutes. They must be sitting somewhere and waiting whose phone they land on. And the fact that they can transfer money illegally from one bank account to another, shows how confident they are that they won’t be caught. There is an increased number of Ugandans embracing digital banking and even a higher number using mobile money platforms. It is convenient and modern. One doesn’t have to always spend hours in the banking halls transacting. It is not 1990 anymore. Digital banking including mobile money had led to some financial inclusion with many people, hitherto unbanked, able to access financial services. There are even people whose only access to financial services is through mobile money. But how safe is their money? If somebody can lose a modern smartphone and within a few minutes they have lost their money, how can the banking and mobile money companies help them? How can police help them? Largely, the majority of Ugandans are left to suffer with losses. Trips to the police to help track the thieves become endless and costly that the majority of Ugandans have given up to even reporting about it. They know there won’t be much help to recover the money. The banks and mobile money companies will largely blame the victim and do everything in their power to protect themselves. Because we have spent much time ignoring these attacks and blaming the victims, the thieves have now gained so much confidence that they are attacking government payment systems. The case of Uganda losing Shs60 billion in 60 minutes when a payment was initiated by the Ministry of Finance to the country’s central bank is still fresh. Although the attack happened in September 2024, not all the money has yet been recovered. And we are talking about government here with all the resources and contacts you can imagine. Imagine how much is being lost by individuals and businesses. Like my friend, a small business owner, the thieves have set her several years back. She wasn’t able to pay her rent and salaries for April on time. She now has to borrow to keep her business running. The police and other security intelligence organs must put in a shift to curb the rampant digital financial and other crimes. Players in the financial industry must also continuously invest in technologies that limit these crimes while sensitizing their clients on these issues otherwise gains made will be lost when people return to old ways of banking or keeping the money in their pillowcases. The writer is a communication and visibility consultant. djjuuko@gmail.com

May 27, 2025

Out to Lunch

#OutToLunch: Favourable interest rates are good for everyone, not just government blueprint for politicians and entrepreneurs building churches

#OutToLunch: A blueprint for politicians and entrepreneurs building churches By Denis Jjuuko When it comes to religion, many times politicians, billionaire entrepreneurs, the middle class and other classes agree. At least on building magnificent houses of God. Across Uganda, many people have contributed or even single handedly built these houses of God. Fancy to a fault, majestically standing on hills with spires that compete with those seen in Hollywood movies. Many of these worship centres, particularly those single handedly built by one person or a family with their friends, are usually located in rural areas where the funders were born, walked barefoot to school before migrating to Kampala to find fortune and fame. The floors are of Italian or Spanish marble, porcelain or at worst polished terrazzo. Stained glasses with the beautiful image of the Virgin Mary complete the curvy life size windows. The pews are of the hardest wood. The world’s best sound engineers come in to install the public address system. The house of God must be fancy. Once construction is complete, they call in their Kampala friends for the grand opening. The clergy lines up at the foot of the building to welcome them. The parking lot is full of the most expensive SUVs. The parishioners walk in every prayer day fearful of stepping on the floors, sometimes so shiny that they see their own body reflections. Their best clothes can’t even be used to clean the pews. They can scratch them. For a moment, the poor are in heaven before returning to their houses where floors are screeded with cow dung. There is nothing wrong with people using their fortune and connections to build grand churches or mosques. It is their money; their appreciation of what God has helped them achieve. They no longer have some of these other problems so they can “give back” to God. The problem is whether the grandeur church is what the community really needs. Shouldn’t politicians, the rich and famous first do a needs assessment? Usually, besides the magnificent house of God stands a school with a falling roof or whose walls are being held in place by crooked timber poles. Windows are just wide openings where mild steel frames would do. Inside some of the classrooms, are anthills. Pupils sit on logs and like their homes, the cow dung is the main material used for floor screeding. Teachers look like they last had a decent meal on Christmas day. The health centre is miles away and poorly equipped. The only hope for survival whenever they fall sick is through prayer in the church built for them by the only person who was lucky enough to survive the biting poverty. Yet the funders go to India or Kenya or Germany whenever they feel any discomfort. And are not afraid to give testimony that last time they fell sick, they traveled to Europe for better management and while there, they were thankful to God for their life hence the magnificent church building. Yet the blueprint for an impactful church exists. In most cases wherever the Catholics built a church, they built a school as well and almost everywhere they set up their regional headquarters (read a diocese), they built a functional hospital. They knew that you can’t pastor the dead! They also knew that an educated population is good for them and their beliefs. Some people call it sustainability and perhaps that is why they have existed for millennia. You saw how they put on a show at Pope Francis’ funeral. Why can’t politicians and billionaire businessmen do the same? If you have Shs6 billion (nearly US$2 million) like we heard of the Ssembabule church or the one in Mitooma, why not build a church of Shs2 billion, a school of Shs2 billion and a healthy centre of Shs2 billion? You could also may be build all those with about 70% of the kitty and create an endowment fund with the remaining 30%. The annual interest from the fund could be used to operate the school and the hospital. If 30% of Shs6b is invested say in a long-term treasury bond, it could give a net return of approximately Shs255m per a year or Shs21.3m per a month, enough to subsidize a rural school and health facility. Alternatively, an income generating project could be established alongside the church building. A factory to add value for the parishioners. It could be a dairy plant or a coffee factory depending on the area. A scholarship for the needy bright students could be another alternative. That way people wouldn’t have to meet their creator ahead of time. The writer is a communication and visibility consultant. djjuuko@gmail.com

May 27, 2025

Out to Lunch

#OutToLunch: Favourable interest rates are good for everyone, not just government only we could learn from Pope Francis

#OutToLunch: If only we could learn from Pope Francis By Denis Jjuuko The death of Pope Francis came a little bit as a surprise. He had been seen publicly on Easter Sunday, another surprise, blessing the faithful from the balcony that overlooks St Peter’s Square. Even though he was visibly weak, it seemed he was on the road to recovery after spending more than a month in hospital being treated of double pneumonia. He was 88 years old. Pope Francis is the third pope to die in the last 20 years following John Paul II in April 2005 and Benedict XVI in December 2022 even though he (Benedict) had long resigned from this position due to ill health. That decision of Benedict to resign allowed Francis to assume office in March 2013. Less than two years after his election, Pope Francis made the long trip to Uganda, becoming the third pope to do so largely thanks to the Uganda martyrs. And like most of the papal visits especially to countries like ours, everything comes to a standstill. Roads are paved, buildings are rehabilitated and grass is planted, public holidays granted and that wasn’t any different in 2015. People traveled from far and near to attend the mass that he led. Even our politicians who usually don’t see eye to eye were seen shaking hands at the Uganda Martyrs Shrine in Namugongo. One wished the pope visited every day! Those who met the Pope either in Uganda, the Vatican or elsewhere all talk about his humility. As he departed Uganda, a photo is shared of him climbing the steps to his Shephard One aircraft at Entebbe International Airport. He was walking alone, one hand sometimes holding his papal soutane, and another carrying a black bag, perhaps with personal belongings. He could have had as many aides as he wished. He was the leader of more than a billion Catholics but he lived simply and perhaps sending a message to nobodies that they too can be humble. Many ministers in Uganda never carry their handbags, there is always somebody at hand to do so. He refused to move in expensive limos or SUVs while visiting Kampala preferring a simple black Kia hatchback. Again, in a country where every public official craves for the most powerful vehicles. He lived simply and probably wanted us to learn something. Servant leadership. Showing off was not his way of life. He also understood that the Catholic Church needed reforms in a world that is rapidly changing. It may not have made him a lot of friends within the conservatives but leadership is about making key decisions including those that are unpopular. That way he endeared many to the church. He wanted a world where peace existed. He prayed for peace and welcomed everyone including many that he probably didn’t agree with. Perhaps if they listened to him, the world would have been different. There would be less destruction. We can all live together. He kissed the feet of warrying parties and urged them to embrace peace. Those whose feet he kissed only shook hands for a day and some are at each other’s throats again. He must have died wondering what needed to be done to stop the wars and killings that go on unabated sometimes fighting for no particular reasons apart from the egos of leaders and wealth that they would still leave on earth. Pope Francis still sent a message to those who deprive wealth of others by stating in his will his desire for a simple burial without the ornaments and all stuff that his position could afford. If he didn’t enjoy a luxurious lifestyle when alive, it would mean nothing to his body. There is a lot that we can learn from Pope Francis. His humility, ability to embrace everyone and putting others first even when it came at a personal cost. He didn’t adhere to the advice of his doctors for complete rest. He kept on meeting people and drove through the crowd in his papal mobile on Easter Sunday. And if leaders can take his example, the world would be a better place. Peaceful and resources shared with everyone. The writer is a communication and visibility consultant. djjuuko@gmail.com

May 27, 2025

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#OutToLunch: Favourable interest rates are good for everyone, not just government, banks must do more to curb digital financial crimes

May 27, 2025

#OutToLunch: Favourable interest rates are good for everyone, not just government blueprint for politicians and entrepreneurs building churches

May 27, 2025