Saving health sector from greed and abuse

Zimbabwe’s health industry has been locked in a crisis for some years now, mainly due to a standoff between health funders and providers of medical services over tariffs, among other contested matters. With the Zimbabwe Medical Association, which represents doctors, warning that it would stop accepting medical aid cards from July 1, in protest over what doctors say is an estimated $220 million in unpaid fees by health funders, the crisis could soon come to a head. The Source takes a closer look at the dispute, which threatens to break the health sector while short-changing an estimated 1,6 million Zimbabweans contributing to medical aid or health insurance schemes. We talk to Victor Mangava, the managing director of Budget Health Medical Aid Society, a health insurer and member of the Association of Health Funders of Zimbabwe (AHFoZ).

Zimbabwe’s billion-dollar health industry is in turmoil. As players in the industry jostle over money, the country’s health standards are falling.

The industry is facing a plethora of problems, chief among them the high cost of medical services, which has excluded the majority of the people. The industry has elevated the more expensive secondary care and neglected primary care, which is key to a healthy nation.

Zimbabwe’s health costs are more than twice that of regional rivals South Africa and Zambia and Asian giant India, according to available data.

In 2015, the Association of Health Funders of Zimbabwe (AHFoZ) — which has a membership of 27 medical insurance companies — said membership for medical aid firms fell 31 percent to 400 000 in the previous year. AHFoZ still collected $400 million in subscriptions, which was all swallowed up by the high costs of service. With the deteriorating economic situation, these numbers declined further last year.

Over the years, too much interference in the health ecosystem has led to problems such as shortfalls, low membership uptake, lack of confidence in the system, absence of guarantee of payment and poor debt control.

The financial repercussions are huge, but the biggest losers are the public who have seen their universal right to quality healthcare usurped by a system that has supplanted them for corporate greed.

Up until 1998, medical aid societies (MAS) were self-regulating. The National Association of Medical Aid Societies (NAMAS), the forerunner of AHFoZ, had peer review mechanisms which included suspending errant members.

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