By Michael Gwarisa
The medical aid industry and healthcare service providers appear to be at odds regarding the proposed Insurance and Pensions Commission (IPEC) Amendment Bill, H.B. 7, 2024.
If passed into law, the IPEC Bill will see the Ministry of Health and Child Care (MoHCC) surrender regulation of the medical aid sector to the Insurance and Pensions Commission (IPEC), which falls under the Ministry of Finance and Economic Development.
The Insurance and Pensions Commission Amendment Bill, H.B. 7, 2024, introduces significant reforms aimed at strengthening regulation, transparency, and policyholder protection in Zimbabwe’s insurance and pensions sector. Notably, medical aid societies will now explicitly fall under IPEC’s regulatory scope.
Medical aid players, represented by the Association of Healthcare Funders of Zimbabwe (AHFoZ), believe that transferring regulatory authority to IPEC would have catastrophic consequences for the healthcare sector.
The challenges facing the healthcare sector require solutions driven by those within the sector, not imposed by external bodies unfamiliar with its complexities,” said AHFoZ Chairperson Mr. Stanford Sisya during a breakfast meeting in Harare.
“We believe that a more constructive approach would involve enhanced collaboration between IPEC and the Ministry of Health and Child Care, such as sharing insights on prudential matters, rather than a disruptive and potentially detrimental restructuring of the regulatory landscape.”
To address the regulatory gap, Mr. Sisya called for the swift finalization and implementation of the “Medical Aid Societies Regulatory Authority” Bill. He stated that AHFoZ believes establishing a dedicated regulatory authority, specifically focused on the unique needs and dynamics of medical aid societies, is the most appropriate course of action.
In the Southern African Development Community (SADC) region, the regulation of medical aid societies and medical insurance companies varies from country to country. Oversight generally falls under insurance regulators, health ministries, or dedicated medical schemes authorities, depending on the jurisdiction. Currently, medical aid societies in Zimbabwe are regulated by the Ministry of Health and Child Care under the Medical Aid Societies Regulations (2000).
Legal expert Mr. Wellington Madya argued that IPEC cannot be the sole regulator for the sector, as doing so would have long-term negative implications for medical aid societies.
“Instead of handing over regulation of the medical aid societies to IPEC, I would recommend the establishment of a transitional regulatory framework, whereby a joint oversight mechanism is implemented during a transitional period (e.g., 12–24 months). This would allow IPEC and the Ministry of Health to co-regulate while aligning standards and clarifying roles,” said Mr. Madya.
He added that such an approach would build trust, ease operational shocks, and give the industry time to adjust. He also recommended forming a Tripartite Advisory Taskforce comprising IPEC, the Ministry of Health, and representatives from AHFoZ and medical insurers. This task force would review overlapping mandates, align regulatory objectives, and recommend a harmonized framework.
Mr. Madya further noted that the healthcare sector operates as an interdependent ecosystem comprising healthcare providers, medical aid societies, and patients. Removing medical aid societies from the oversight of the Ministry of Health and Child Care, he warned, carries a significant risk of destabilizing the sector.
While the medical aid sector believes IPEC should not regulate the industry, healthcare service providers hold a different view.
Representing the Zimbabwe Medical Association (ZIMA), Dr. Musvo Mapfanyangira argued that involving IPEC would improve transparency and operational issues.
“We are for transparency. I am not for one side—I am for the patient. The question I have is: how did we get here? Why are we now saying we need IPEC? Something must have triggered this conversation. It means something is amiss with the way things are being handled; otherwise, if things were smooth, we would not be here,” said Dr. Mapfanyangira.
She added that they are working on an initiative to curb fraud and corruption in the medical aid sector in collaboration with AHFoZ.
“We are working on what is called the AHFoZ-ZIMA Fraud Committee because there has been a lot of talk about fraud. As we speak, the fraternity is leaning towards IPEC, and we ask the question: does changing the regulator make a difference? I go back to my question—what has happened over the past decade that has caused a rift between service providers and healthcare funders?”
On the other hand, private healthcare service providers believe they will not be directly affected but acknowledge potential ripple effects from the IPEC Bill. They argue that having IPEC on board would address various irregularities in the medical aid industry.
Advance Masarirevhu, Vice Chairman of the Private Healthcare Association of Zimbabwe (PHAZ), described the IPEC Bill as a necessary intervention for the medical aid sector.
“There has to be some sort of supervision for our funders. We looked at the bill and found that it would enhance oversight. The oversight was not enough, and there was a need to improve it—hence the formulation of this particular bill. There was also the issue of protecting consumers, which is why we have this bill before us,” said Masarirevhu.
He added that current regulatory standards were inadequate and needed improvement. He suggested that the Ministry of Health and IPEC could play complementary roles in the regulation process.
“The Ministry can look at the social aspect of things—that is, ensuring everyone has access to healthcare. IPEC, on the other hand, can focus on the economic and financial aspects. They have the expertise to assess the financial positions of funders, scrutinize them, and ensure that consumers are protected.”
Prior to the year 2000, medical aid societies were entirely self-regulating and successfully delivered on their mandate. In 2000, the Medical Services Act (Chapter 15:13) was enacted, followed by the Medical Services Regulations SI 330 of 2000, as amended by SI 34 of 2004. Over the years, medical aid societies have been crucial partners with the government in facilitating access to healthcare services, contributing a significant 80% of the income for healthcare service providers.
