PROPOSED plans to bar medical aid societies from owning hospitals and clinics can unleash a healthcare affordability crisis in the country, leaving millions drowning in medical bills, stakeholders have said.
The government has proposed amendment to section 14 of SI 330 of 2000 to separate medical aid societies from healthcare service ownership. Under the proposed changes, medical aid societies will be prohibited from owning or operating healthcare facilities.
Critics say the measure is intended to force medical aid schemes to outsource all clinical care to independent, third-party providers.
Several medical aid societies run their own primary care clinics, offering affordable consultations, basic diagnostics and medicine to members — often at rates far below private-sector alternatives.
Stakeholders appearing before the Parliamentary Portfolio Committee on Health and Child Care mounted a strong defence for vertically integrated medical aid systems. They argued that medical aid-owned hospitals, clinics, pharmacies and laboratories have become the remaining buffer against catastrophic out-of-pocket healthcare costs.
They warned that dismantling the current model without a viable affordable alternative can push thousands of Zimbabweans out of medical aid coverage.
Institute of People Management of Zimbabwe representative, Tinotenda Mushapaidze, said employers and human resources practitioners were deeply concerned about preserving affordable healthcare access for employees.
“We need proper access to healthcare without excessive out-of-pocket costs and this is something medical aid societies have been able to provide,” she told the committee.
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Mushapaidze cited a case in which a patient was asked to pay US$600 upfront per night at a private hospital before admission.
“The patient was later transferred to a facility owned by a medical aid society, where they were admitted without any upfront shortfall,” she said.
“After spending three days in the hospital, the total shortfall bill was only US$30.
“That is affordable access to healthcare delivered at the right level and with positive outcomes for the patient.”
Mushapaidze warned that removing vertically integrated healthcare structures will expose workers to unsustainable medical expenses at a time when salaries are under severe strain.
“If we continue on this path, we can ensure that employees continue to access quality and affordable healthcare,” she said.
MASCA Medical Aid Society chief executive, Doug Bramson, said pensioners would be among the biggest casualties if medical aid societies were stripped of their healthcare delivery infrastructure.
Bramson said many pensioners were surviving only because they could access Cimas clinics, pharmacies and hospitals without making heavy co-payments.
“The message from pensioners was simple: ‘Please don’t let this happen, otherwise we will not be able to afford medical aid and the associated shortfalls,’” Bramson said.
They explained that in the past they paid a co-payment of US$50 to US$60 just to see a general practitioner, but now they can access Cimas clinics, pharmacies and dentists without making such co-payment.”
He warned that forcing pensioners back to fully commercial healthcare structures will render thousands unable to access treatment.
“Even within the 8 to 10% of Zimbabweans covered by medical aid, pensioners are already struggling to pay contributions, let alone significant co-payments,” Bramson said.
Some stakeholders acknowledged concerns around preferred provider systems and allegations of delayed payment to independent doctors, arguing that reforms should focus on fairness and accountability rather than dismantling integrated healthcare systems.
Healthcare executives defended preferred provider networks as a cost-control mechanism designed to reduce co-payment and improve affordability.
“The most that happens is that members are provided with a list of service providers they can use without paying a co-payment,” one healthcare executive said.
“Ultimately, however, members still choose where they want to go.”
Ultramed Health chief executive Sibling Mukonoweshuro warned that the SI 330 debate ignored the brutal economic realities confronting ordinary Zimbabweans.
“People simply do not have money,” Mukonoweshuro said.
He said many healthcare professionals and policymakers were disconnected from the realities facing low-income households.
“We introduced a US$5 product and people laughed at it,” he said.
Mukonoweshuro warned that dismantling medical aid-owned healthcare facilities will expose patients to massive upfront treatment costs running into thousands of US dollars.
“If you remove medical aid clinics and these healthcare facilities, you are left with a patient earning US$250 who somehow has to raise US$5 000 before a doctor will touch them,” he said.
Mukonoweshuro also questioned the sustainability of healthcare pricing structures in Zimbabwe.
“We must recognise that we do not live in a wealthy society that can sustain the level of fees currently being charged,” he said.
Others warned Parliament that weakening medical aid societies’ service delivery capacity can destabilise one of the few remaining systems still cushioning Zimbabweans from runaway healthcare costs.
They urged Parliament to prioritise affordability, service access, jobs and long-term healthcare investment before approving changes to the law.
