National Medical Aid Scheme Key To Universal Health Coverage

THE long overdue establishment of a National Health Insurance Scheme is crucial in achieving universal health coverage as Zimbabwe explores various ways to increase domestic funding for patching up the bleeding healthcare delivery system.

By Kudakwashe Pembere

This was recommended during the Universal Health Coverage celebrations hosted by the Community Working Group on Health in Harare on Wednesday.

This submission comes at a time when resources in the health sector are heavily constrained with doctors on strike on one end, as well as the obtaining deterioration of the country’s healthcare delivery.

Ministry of Health and Childcare Policy, planning,monitoring and evaluation deputy director Tonderai Kadzere said government finished coming up with a roadmap for the national health insurance scheme.

“So what can we do the national health insurance is alsoone of the key issues. Im just picking up key issues. But the policy is, is Zimbabwe ready for a National Health Insurance. We have developed a roadmap to say now if we want the national Health insurance this is the direction. But nowdo we have the resources. Is this a redistributive policy? Should a country first grow the economy then develop this? Because as it is right now, its the indigent we are talking about the elderly  someone has to pay for them,” he said.

He also said that other countries like Rwanda have enjoyed quality healthcare coupled with economic prosperity for decades.

“These are some of the issues and we know that for the countries that have implemented the national health policy, they have enjoyed about three decades of serious economic growth. And they are now redistributing that policy. But can we move in that direction as Zimbabwe because about 8percent are covered by some form of insurance but when we come up with a framework for that to say we have a National Health Insurance policy that will work. It has government resources in it. Individuals should also contribute to it,” he said.

He also said they had shelved the idea while they are still looking for a worthy manager of this National Health Insurance Fund. He said Premier Medical Aid Society was ideal since they insure over 90 percent of civil servants.

World Health Organisation’s Dr Stanley Midzi recalled that the National Health Insurance Fund was suggested to be handled by National Social Security Authority (NSSA) infamous for corporate governance glitches. He suggested the fund be handled by a corruption free, accountable and transparent organisation. Dr Midzi referenced the National Aids Council of Zimbabwe which has been managing the AIDS levy for almost two decades. He said such an approach after capacitation should be taken.

“We understand the idea was passed in parliament some years ago. But the problem is now they wanted to house it under NSSA. But the problem is with NSSA’s history with managing pension funds such that they were reluctant, they had no confidence with this fund to be put NSSA because it didn’t look like it’s efficient. That’s what stalled. All civil servants, almost 90 percent of civil servants are on PSMAS so they didn’t see it necessary to have another insurance which would deduct their money and get double insured. I was of the idea that government would make that decision that the funds from PSMAS moved so that civil servants who are already covered won’t suffer an extra deduction.

“And of course NSSA was found to have questionable  administrative systems, why can’t they decide to house this fund in a different, I don’t want to propose, but in a way like National Aids Council which has been managing the 3percent AIDS levy very well. For over two decades it has been in operation. Of course there have been challenges here and there. In general they have shown they are able to manage a fund of that magnitude. Why didn’t government look at ways of capacitating or strengthening NAC and put such a fund under such a mechanism. Until NSSA cleans its act it will create confidence that perhaps NSSA can get this fund,” he said.

Given that there are those who can pay for their medical expenses while on the other hand are some who cannot, one participant said the idea of individuals contributing to the national medical aid scheme was welcome. However, a pastor countered the notion citing the high unemployment rate which he saw making the idea of contributions far-fetched.

Another participant from the workers said despite the National Medical Aid Scheme being noble issues of corporate governance of the fund should take centre stage.

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