CIMAS chief executive officer, Vulindlela Ndlovu
Zimbabwe: Less than 10% of population covered by medical aid
HARARE – Zimbabwe’s economic meltdown has made it difficult for the generality of the people to afford health care, with experts revealing that less than 10% of the country’s population is covered by medical aid.
The majority of pharmacies in the southern African nation have been refusing to issue drugs to patients on medical insurance, insisting on cash payments.
The Zimbabwean Health Care Industry is characterized by membership fund challenges, rising costs and inadequate national budget allocation.
CIMAS chief executive officer, Vulindlela Ndlovu, said subscriptions have been falling significantly due to the economic environment which has reduced disposable incomes as salaries are not moving in tandem with inflation and foreign exchange rate movements.
As expected like any other business, the sector has been facing acute forex shortages. Foreign currency is used to procure consumables.
The problem started late 2017.
“We started seeing the prices of medicines moving, for our members we cushion them and we cushioned them up to this year. Between 2017 and early this year I think the prices of medicines rose about 50% and we absorbed that but this year we could no longer continue. It was out of control that’s when we started having increases on contributions,” he said.
“That was the pressure, but for about 18 months we carried those increases. Why the medicines were most affected? Because of the issue that I mentioned that they are imported. This has affected our sector and you will recall that in the beginning of last quarter last year, I think it was after July services providers started charging USD. It was prevalent in our sector. It was a response to what was happening in the market.”
Shortfalls and co-payments, lack of information, unfavorable outcomes from disintegrated practices, affordability of contributions, prevalence of non-communicable diseases (NCDs) and shortage of critical specialists are some of the problems which members are facing.
Also lack of common tariff disintegrated practices has been singled out as the reason medical cover is so expensive.
The issue of lack of an agreed price between service providers and medical aid societies has been talked about each and every year without reaching a consensus, he said.
“As CIMAS we really don’t believe that they should be agreed prices because agreed prices is collusion. The world is moving, at the end of the day there should be an agreement between us as a medical aid and service providers that we work with on a be to be arrangement. Historically in this country may be 20 years ago they used to be a common tariff that was agreed between Association of Healthcare Funders of Zimbabwe (AHFoZ) and the service providers it fell apart at hyperinflation and we have never recovered from that.
“We even lost at the time when there was price stability under the US Dollar we could not agree on short falls, so this is a major problem. So our answer to this is that let’s strengthen the business to business initiatives so we should negotiate with our service providers and agree with them,” he said.
With that, medical based tourism is now cheaper because an integrated system, bargaining power of specialists is less because there is more of them.
Challenges facing service providers include unreliable comparative information on quality and outcomes, no agreed common tariff between funders and service providers, little financial incentives for service providers to coordinate amongst each other to deliver more efficient care, overall health outcomes could be better, delayed claim payments by some funders and foreign currency shortages for imported supplies.
In 2017, the Minister of Health & Childcare (the Ministry) circulated a draft a bill to establish the Medical Aid Societies Regulatory Authority and also to amend the Medical Services Act. In June this year, health minister Obadiah Moyo said the government is now at an advanced stage in the crafting of a National Health Insurance Bill, which will provide a national health safety net to all citizens.
However, the Ministry of Health’s Budget allocation is +/- 7% well below the recommended 15% per Abuja declaration.
