What Parirenyatwa said about the doctors and medical aid societies debacle- Full debate in Parliament

Hon. Mashakada you talked about the issue of co-payments, that if Zimbabwe Medical Association (ZiMA) and Association of Healthcare Funders of Zimbabwe (AHFoZ) do not agree then there will be co-payments.  This is what is happening now and we do not like co-payments at all, because they make the patients suffer.  The patient has already paid their insurance, now they go to the doctor and they are asked for more money.  We think it is unfair to the patient.  So as far as we are concerned, we were forced because they did not agree, we were forced to put up a tariff as a Ministry and regulator, but again it is giving its own problems.  Again we hope that they will break that impasse by some agreement and I hope that when they come on Monday, because when we parted on Monday the doctors and medical insurances were going to meet under the National Tariffs and Liaison Committee and I hope that on Monday we will have good news that they will have agreed on some way of breaking this impasse.

Hon. Mashakada you also say what is wrong in the medical aid or medical insurance investing into businesses like hospitals, clinics, pharmacies, laboratories and others?  This is a very contentious issue among healthcare providers themselves.  The healthcare providers are saying if you take a specialist Urologist, for example he is saying look, I have trained for this, that is my core business and I do it with the passion that I have.  Now the medical aid comes in, they do not actually have money invested elsewhere, they take money from the clients and that is the packet they make.

After that now, when people are paying their money, instead of that money being benefited into the medical industry, what they are doing now is to say right, as a medical insurance we are now going to put up a pharmacy, so we prefer our clients to go to that pharmacy.  Those pharmacies that are not under that are then compromised because even payment will be preferred to those pharmacies.  So there is thorough conflict of interest that you are an insurance that is giving money to a provider and yourself as a provider – there is that conflict.  The Bill that we are crafting seeks to address that issue of conflict and I am certain that the issue that you are saying is an investment is well accepted but how can the medical industry benefit from that investment without bringing in conflict, so that is where I think we are.

The issue of over-servicing of clients, yes, it is a thing that I think we have said there should be an appropriate audit.  It is true a lot of medical aid societies have put up what they call, managed healthcare.  They actually have their own doctor who then monitors what other doctors are saying or doing, then they say you are over-servicing here.  This person came with a cough and you instructed them to return in three days with the same condition.  Why did you not refer or do something else?  So I think it is a fair issue but I think it is being addressed by the insurers and doctors themselves as part of ethics.

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