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Medical aid societies fail to provide health cover

MEDICAL aid providers will this month fail to provide health cover for their clients after the National Incomes and Pricing Commission (NIPC) barred them from increasing service fees.

Private doctors now charge between $100 million and $240 million for consultation, fees that are way above those currently covered by medical aid societies. 
One of the country’s leading medical aid societies, Medical Aid Society of Central Africa (Masca), last week wrote to its members notifying them that they would experience huge shortfalls as what they are contributing could not cover their health bills.
“We have now been informed that, after the March 12 meeting, the National Incomes and Pricing Commission would not approve any increases,” wrote Masca. “This then means that the January tariff would be used to pay any claims despite the fact that some service providers were granted approval to increase their tariff by 800% back-dated to January 2008! This decision will only see the members facing even larger shortfalls.”
Masca said the prevailing harsh economic environment in the country had witnessed marked increases in the prices of goods and services.
The increases, the society said, were sharp in the medical sector due to the high level of import content of most items used.
“This has seen a serious erosion of benefits to our members to the extent that the relevance of medical aid societies is being questioned. Members are running out of drug benefits and are also facing sizeable shortfalls whenever they seek medical attention,” the aid society said.
The society said until contributions are reviewed upwards by the NIPC, members would have to make cash payments to private doctors.
“We are therefore appealing to our valued members to bear with us as we face a situation we do not have any control over. We appreciate that members may have to make up-front payments and we urge them to submit their claims as soon as possible to enable us to pay our awards in the shortest possible time,” Masca said.
The NIPC, however, defended its move not to allow medical aid societies to hike their fees.
NIPC chairman Godwills Masimirembwa in an interview with the Zimbabwe Independent this week said his commission cannot allow medical aid societies to hike their fees as this could result in some employees having their salaries eroded by medical aid contributions.
Masimirembwa said his commission is proposing that employers contribute at least 80% of their workers health cover.
“We are asking industry to contribute voluntarily at least 80 % of their workers’ health cover in order to avoid a situation where salaries are eroded as a result of medical aid contributions,” said Masimirembwa.
Masimirembwa said if companies pay for the bulk of health cover of their workers his commission would then assist them to recover their money through pricing of their commodities.
The umbrella body for medical aid societies, the Association of Health Funders of Zimbabwe, yesterday said they were still engaging the NIPC.
Tapiwa Bwakura, the secretary-general of the Zimbabwe Medical Association, said the fees
being charged by the private doctors were in line with the prevailing economic environment in the country.
“We had to review our consultation fees as everything has gone up from fuel to sundries that are required for a doctor to attend to a patient,” said Bwakura.

By Lucia Makamure

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