By Michael Gwarisa
Health and Child Care Minister, Dr Douglass Mombeshora has called Medical Aid and Health Insurance companies to provide services that respond directly to the ever-changing health landscape And emerging challenges.
He said this while officially opening the 15th edition of the Association for Healthcare Funders of Zimbabwe (AHFoZ) Annual All Stakeholders Conference on Health IN Victoria Falls. The conference is running under the theme “Zooming in on Health Outcomes – “Making the Main Thing the Main Thing.”
As you gather at this year’s AHFoZ conference, whose agenda falls under the overarching framework of the National Development Strategy 1 (NDS1), it is imperative that all players align their efforts towards achieving measurable results. Government fully understands that the realm of health is dynamic and ever evolving,” said Minister Mombeshora.
He added that discussions surrounding health-related issues were ongoing conversations that require constant attention; more so given the emerging health challenges, shifts in disease patterns, and the impact of social determinants including climate change.
“Adaptability requires continuous learning and this conference is one such platform for learning. On that note, I wish to thank AHFoZ for introducing the concept of “Healthcare innovation workshops”, in the true spirit of NDS1.”
He also said government was committed to collaborate with all stakeholders in the healthcare supply chain and form synergies to create home -made solution for our Universal Health Coverage (UHC) needs.
“Financing of healthcare systems has become a global challenge, especially to low income countries like ours. Zimbabwe is working hard to institute reforms that are designed to increase domestic funding for health. One key reform that has been on the agenda for long but being accelerated now is the establishment of a National Health Insurance Scheme. The principles for the Bill on National Health Insurance (NHI) were submitted to Cabinet,” said Dr Mombeshora.
Meanwhile, the Ministry of Health is reviewing some health legislation to better respond to challenges and trends of the day. These include amendment of the Health Professions Act to strengthen regulation of health professions and create enabling environment for health investment. The Medicines and Allied Substance Act is also being amended to expand and strengthen regulation of medicines and medical products. A critical feature of this amendment are provisions allowing regulation of medical devices by MCAZ.
Ms Shylet Sanyanga, the AHFoZ CEO said Medical Aid comapies should be innovative eough to navigate the recurring issue of shortfalls.
“Medical aid societies are required to give prior Notice to their members on any pending increases in contributions. Members and employer organisations are not always able to absorb proposed increases. This often results in a mismatch which causes shortfalls. It should be noted however, that there are other causes of shortfalls such as; Exhausted annual global limit/benefits, Suspended membership, Exchange rate mismatch, the difference in fees charged by provider and the AHFoZ Tariff,” said Ms Sanyanga.
She added that another major cause for shortfalls was when medical aid subscriptions are pegged below actuarially recommended rates; in such instances the Healthcare Funder will be collecting subscriptions that are not enough to cover the claims costs. Its liquidity status will not be able to absorb the fees expected by service providers.
“The Healthcare Funder aid will therefore reimburse at levels affordable to it leaving the balance to be collected by the service provider as a shortfall at the point of care. AHFoZ urges its members to use actuarial expertise for determining medical aid subscriptions to set correct contribution levels and realistic global limits thereby reducing shortfall incidences. This is because member contributions are the only source of revenue for medical aid societies.”
