The Association of Healthcare Funders of Zimbabwe (AHFoZ) has raised concerns about a proposed amendment to Statutory Instrument 330 of 2000 that would bar medical aid societies from owning clinics, pharmacies or hospitals.
The amendment, put forward by the Ministry of Health and Child Care, seeks to stop medical aid societies from providing healthcare services, limiting them to their core role of pooling funds and buying services for members.
AHFoZ chief executive Shylet Sanyanga was quoted in the media recently saying an outright ban would be a setback.
“When we look at the ban or prohibition of medical aid societies from going into healthcare services, that is, banning them from owning clinics and hospitals, we believe that would be a retrogressive position. It will take away the current option that medical aid members have,” said Sanyanga.
“If a service provider rejects their medical aid card, they have at least the option of going to their medical aid society’s units.
“But if those units are forced to close, patients are left at the mercy of service providers who may not be willing to accept medical aid as a form of payment.”
She said the facilities play an important role in the health sector by providing services and easing pressure on the country’s healthcare system.
“If anything, those facilities are actually contributing to offering healthcare services, not only to medical aid societies’ members, but to any other patient seeking healthcare services,” she said.
AHFoZ also wants to move to a “risk-based capital” model. This is a way of checking that insurers have enough money set aside to cover risks, to keep the sector financially stable.
One medical aid member, who did not want to be named, said ordinary policyholders would lose out. He said it would be harder to get treatment, and patients would end up paying cash as well as their monthly medical aid fees.
“The reason these clinics and pharmacies were created is that ordinary medical aid holders were failing to get services from private medical practitioners,” he said.
“You would be told the medical aid was not working there, so they needed cash because medical aids were delaying payments to service providers. Some would even require unnecessary top-ups.”
He said the government should deal with rising and unpredictable prices in healthcare, rather than banning insurer-owned clinics.
“Pricing is not stable. Everyone charges what they want, depending on the desperation of the patient.
“Issues of health are a matter of life and death, so you have no choice but to pay.
“Exchange rate issues also need to be addressed. You go to a practitioner, they charge in US dollars; if you ask for the charge in local currency, the price triples, even surpassing black market rates,” he said.
He added that fees were already high, especially for people paying in local currency. He said the rates were far higher than black-market rates.
“I pay ZiG7,000 (close to US$300) for myself and my three children, not even for the best medical aid. That is what the government should be reigning in,” he said.
Batanai HIV and Aids Service Organisation (BHASO) director Farai Mahaso suggested an alternative to a ban.
“Instead of banning medical aid societies from owning healthcare facilities, adopt conflict-of-interest safeguards such as transparent pricing and independent audits, while strengthening solvency rules and member protections. This balances regulatory clarity with affordable access,” said Mahaso.
More: TellZim News
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