Saving health sector from greed and abuse

This association included in its membership, medical service providers (MSPs). This association developed tariffs which were applicable to both members and MSPs who were registered with them. This was in order to protect members from abuse by unregistered practitioners.

MSPs also had their own association, but they used the NAMAS tariff in which they had a role in setting through the National Tariff Liaison Committee. The committee was actually headed by an MSP.

The government also provided medical services and had tariffs applicable to different institutions, which were heavily subsidised by the state. This was very convenient for everyone.

MAS, MSPs and the state were in harmony and a law was enacted to make sure that everyone understood their roles.

A young medical practitioner, Paul Chimedza, changed all that when he was elected president of the Zimbabwe Medical Association (ZiMA), the sole representative association for all medical doctors in the country.

Chimedza claimed his right to charge a tariff he felt appropriate for the services rendered, and his association agreed with him. This led to a ZiMA tariff which was much higher than the NAMAS tariff.

The tariff was based on model from the developed world.

Medical aid societies, whose subscriptions were based on a much lower NAMAS tariff, were faced with many challenges.

The new tariff strained relations with service providers who wanted payment based on the much higher ZiMA schedule.

Employers, who at the time were providing medical aid subscriptions as a condition of employment, started pulling out due to the high costs. This reduced the membership in medical aid companies. The higher cost of medical services pushed the premiums up at a faster rate, making them unaffordable. More members dropped out.

That period also saw the entrance into the health sector by insurance companies who started offering savings funds that also covered medical aid. The new entrants, who included Fidelity, First Mutual and TN Medical Fund, were incorporated into NAMAS, which changed its name to AHFoZ.

The development meant that MAS were now facing competition from the new entrants for what was becoming a shrinking customer base.

The largest medical aid society, Premier Service Medical Aid Society (PSMAS), decided to invest in its own facilities under its Premier Service Medical Investments (PSMI) vehicle, which charged much lower rates than the ZiMA tariff.

The move by PSMAS actually saved the industry from collapse as smaller MAS referred their members for treatment to its cheaper facilities.

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