THE government’s proposed move to bar medical aid societies from owning hospitals and clinics may be well-intentioned in theory, but in practice, it risks unleashing a tsunami on one of the few functioning safeguards still protecting ordinary Zimbabweans from catastrophic healthcare costs.
At a time when incomes are stagnant, inflationary pressures remain unpredictable, and out-of-pocket healthcare payments are already pushing households to the edge, this proposal is not reform — it is disruption without a safety net.
The argument being advanced is that medical aid societies should focus strictly on financing healthcare, leaving service delivery entirely to independent providers. On paper, this may appear clean, competitive, and market-friendly. On the ground, however, the story is different.
Medical aid societies did not initially set out to invest in hospitals and clinics. They were forced into doing so to protect their subscribers.
They stepped in when members were routinely hit with crippling shortfalls or told their medical aid cards were not accepted at critical moments of care.
In response, they created a vital cost-containment ecosystem.
This gave rise to vertically integrated medical aid societies operating clinics, pharmacies, and hospitals to protect subscribers.
The system has cushioned members from excessive shortfalls.
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A recent example illustrates this clearly: a patient was once asked to pay US$600 per night upfront at a private hospital. The same patient was later treated in a medical aid-owned facility and walked away with a total shortfall of just US$30 after several days of admission.
This demonstrates how the current system has become a financial buffer for members.
Removing it would leave patients exposed to a fully commercialised healthcare market where upfront payments of thousands of dollars are not exceptions — they are entry requirements.
This comes at a time when public hospitals are in intensive care themselves, struggling with drug shortages, lack of sundries, and a demotivated workforce.
It calls for a policy rethink.
Zimbabwe operates in a high-cost, low-income economy where medical aid societies have effectively become shock absorbers for systemic healthcare failure.
Removing their service delivery capacity without first fixing affordability in the broader private healthcare sector is equivalent to removing the floor while the building is still shaking. It is like building on clay.
There is also a deeper governance issue. Reform should not be driven by structural ideology alone, but by measurable outcomes for patients. If the objective is lower costs, improved access, and reduced out-of-pocket expenditure, then the central question is simple: will this policy make healthcare cheaper for ordinary Zimbabweans?
On current evidence, the answer is no.
Even more concerning is the timing. The healthcare system is still recovering from years of currency volatility, pricing distortions, and uneven access. Introducing a structural overhaul now risks destabilising the remaining pockets of affordability before credible alternatives are in place.
A more rational path exists — and government should consider it.
Instead of dismantling vertically integrated medical aid systems, policymakers should focus on regulating pricing transparency, strengthening oversight of preferred provider arrangements, and enforcing accountability where delays or unfair practices occur. Reform should refine the system, not fracture it.
Affordability must remain the central test of any policy decision — not ideology, administrative neatness, or abstract market theory.
If Zimbabwe is serious about universal healthcare access, it cannot simultaneously remove one of the few mechanisms currently keeping treatment within reach for ordinary citizens.
The government should reconsider this proposal in its current form. Don't delay. Don't dilute it. Abandon it — and engage stakeholders in designing reforms that expand access without collapsing affordability.
Because in healthcare, the most dangerous reform is one that improves structure on paper but worsens survival in reality.
The biggest winner in any health reform process must be the patient. The proposed reforms risk making the patient the loser.
There is, ultimately, a real danger of throwing out the baby with the bathwater.
