New Zimbabwe.com

Doctors calls upon anti-graft body to investigate health insurers

By Robert Tapfumaneyi


DOCTORS under the banner of the Zimbabwe Medical Association (Zima) have called on the Zimbabwe Anti-Corruption Commission (ZACC) to investigate all medical aid societies for possible misappropriation of trust funds.

Zima claims its members are owed in excess of $60 million by medical aid societies in unpaid services and argues the failure is due to money being diverted to cater for the lavish lifestyle by senior managers.
The doctors want health insurers to disclose to the public how much is being spent on subscriber benefits viz-a-vie other administrative expenses.

“Medical insurance firms are mushrooming everywhere collecting subscriptions upfront from patients. They are top heavy and are using funds meant to pay for services for non-member benefits on lavish lifestyle and top of the range vehicles, resulting in members incurring huge shortfalls,” Zima secretary general Sacrifice Chirisa said.

“When the insurer becomes the service provider and directing patients to their own institutions, patient care outcomes deteriorate. Long waiting times for patients become common. This is unethical, anti-competitive and compromising patient outcome and quality of care.”

Chirisa told journalists at a press briefing in Harare, Wednesday that medical aid societies have failed to pay for services in full and in time with some having outstanding claims dating to as far back as 2015.

“Medical aid societies are not paying on time and in full, therefore breaking the law. The Association of Health Funders of Zimbabwe (AHFoZ) has announced increases in tariffs twice this year in (February 2019 and in July 2019) but none of its members have complied with this, despite increasing members contributions.

“At some medical aid clinics, practitioners are literally targeting clearing patient queues rather than offering quality service resulting in a single doctor attending to outrageous of more than 80 clients in a day compromising significantly on quality of care,” Chirisa added.

The doctors said State owned Premier Medical Aid Society (PSMAS) has not paid medical practitioners for the past seven months.

“PSMAS owes us an estimated figure of about $60 million and the rest of the medical aid societies are still owe practitioners but what has happened is that they are not sticking to the stipulated time of payments,” Chirisa fumed.

He added that the delays in payment by health insurers have resulted in loss of value due to inflation.

Health Minister Obadiah Moyo has also raised the red flag over what he called could be conflict of interest when medical aid societies run hospitals.