Zimbabwe Proposes Ban On Medical Aid Societies Owning Clinics, Pharmacies

Some health sector stakeholders have thrown their weight behind a proposed amendment to Statutory Instrument 330 of 2000, which 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.

Community Working Group on Health (CWGH) executive director Itai Rusike backed the proposal, arguing that medical aid societies cannot be both fund managers and care providers without losing focus on their core business.

“They cannot be fund managers and care providers because it will be difficult for them to focus on their core business of pooling resources and purchasing services on behalf of their clients. While the idea was meant to minimise care, that has since been abused,” said Rusike.

He said some providers collude, citing doctors who refuse to allow diagnostic tests to be carried out by any laboratory except one they favour.

Rusike added that small medical aid societies had lost business, and that the few patients they still saw, mostly uninsured or underinsured, were charged exorbitant fees to make up for low volumes.

“Health care is not an ordinary good, such as bread or drinks, where one can choose either to consume or not,” said Rusike.

“Sickness always comes unexpectedly, and when sick, people have no freedom or luxury to make choices.

“This desperation is then taken advantage of by providers of care. Maybe what this is all pointing to is the need for a well-defined and well-crafted National Health Insurance Scheme.”

A doctor, speaking on condition of anonymity, agreed with Rusike, comparing the current system to a football league regulator owning its own team.

“The current situation is not proper because there are no checks and balances. If you are the one providing insurance, you are saying you are covering the medical risk. You cannot be a service provider; you have to strictly be a funder. If you provide that service, who will guarantee value? Who will determine quality?” the doctor asked.

The doctor argued that insurers should not run clinics and should focus instead on quality assurance to ensure members get the care they are entitled to.

“It is daylight robbery to the beneficiaries. If we don’t address this, everyone will start venturing into medical aid societies, then they will want to establish hospitals and start giving substandard services, and patients will suffer,” said the doctor

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