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Errant medical aid societies should be dealt with once and for all

Opinion & Analysis
The Health ministry is the regulator of medical aid societies and is responsible for renewing licences for the health funders.

I GOT the shock of my life when Harare Municipal Medical Aid Society (HMMAS) called me on Tuesday afternoon to inform me of the impending payment of ZWL$300 000 the only payment to be made after 8 months.

I figured out how on earth a medical aid society would boast of paying an equivalent of US$30 and then expect us as medical practitioners to continue entertaining it?

Dividing that figure by twelve months gives an average of US$2,50 a month, an abominable amount that pushes us to think if it is even worth accepting such a medical aid society.

Waiting to pay service providers when one is sure that the money has lost value is not only absurd but a clear sign of disrespect of the celebrated medical profession. The patients are the ones to bear the brunt of the poor service by the medical aid society. Why then should city council workers continue to endure poor health cover which is equated to almost nothing?

The triad of medical service includes patients, service providers and medical aid societies in our country. It is a pity that patients seem to experience a “double pashashe” as they are forced to pay monthly premiums to some aberrant medical aid societies at the same time being denied medical care merely because their respective medical aid societies do not honour service providers’ payments.

The Health ministry is the regulator of medical aid societies and is responsible for renewing licences for the health funders. Why does the regulator continue to issue licences to obstinate medical aid societies that continue breaching their obligations?

Many people die because of failure to access medical attention as a result of non-payment of dues by medical aid societies. The same unscrupulous medical aid societies have their executives enjoying huge perks including driving state-of-the-art vehicles at the expense of health service delivery.

Premier Service Medical Aid Society, HMMAS are some of the organisations that should work very hard if public perception is to improve. People should garner enough confidence if the acrimony between the medical aid societies and service providers is to ease. No service provider desires slavery in this era and age.

Service providers have lamented the poor service delivery by health funders for a time immemorial. No solution is in sight. Areas of conflict of interest have been highlighted with the issue of medical aid societies delving into medical practice being topical. Many clinics and hospitals run by medical aid societies have sprouted in the past few years and one wonders where these medical aid societies get huge sums of money for capital budgeting yet they cannot pay service providers in time. Some medical aid societies have

 the tendency to divert their clients to specific service providers whom they will pay handsomely at the detriment of others. Why is the regulator quiet when complaints are rampant on a daily basis? Are there elephants in the house of the medical industry that bulldoze all other players? This habit should surely be extinct by 2024.

I am not sure why some medical aid societies want to belittle our hard-working practitioners. It is astounding to note that some of the health funders are nicodemously approaching service providers to negotiate specific tariffs like consultation fees. There was one such that wanted to pay just US$5 for consultation instead of the gazetted US$25 of 2014. Such arrogance is an attack on our profession and should never be tolerated by all sober-minded people in this country. The same medical aid societies are increasing monthly premiums yet they want to reduce tariff charges. All this is done to maximise profits at the expense of service delivery.

It is time the Health and Child Care ministry took drastic action against malpractices in the health sector that have potential to derail health service delivery. It is indeed a mammoth task but positive results will come sooner than later.

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