…as Nssa, Psmas haggle over health insurance scheme
PUBLIC Service minister Prisca Mupfumira is caught in the middle of a dispute as the National Social Security Authority (Nssa) and Premier Service Medical Aid Society (Psmas) are failing to agree over a proposed partnership, the Zimbabwe Independent has learnt.
By Hazel Ndebele
Sources close to the developments say Mupfumira, through her ministry, is pushing for the two institutions to partner so that she could be seen as delivering as a minister since the partnership will aid the setting up of the National Health Insurance Scheme (NHIS).
Mupfumira has been pushing for the NHIS, arguing that it is government’s mandate to ensure that vulnerable segments of society must have medical cover. A fortnight ago Mupfumira said those opposed to the NHIS were detractors who did not want to see government providing accessible healthcare to the people.
Due to pressure to deliver on the NHIS despite the fact that government is broke, Mupfumira is now driving a hard bargain in the negotiations between Nssa and Psmas.
Sources told this paper that she wants the NHIS to benefit from Psmas’ existing infrastructure such as its investment arm Premier Service Medical Investments (PSMI)’s clinics and hospitals. PSMI has more than 100 service centres across Zimbabwe and a presence in Zambia.
The NHIS is expected to start before the end of the year and before the 2018 general elections. However, this paper is informed that the Nssa-Psmas partnership has been in limbo since October last year when Nssa wrote a preliminary proposal to partner with Psmas.
The preliminary proposal for the partnership of the institutions drafted by Nssa and seen by the Independent states that the tie-up would help improve Zimbabwe’s health delivery system.
However, sources say Psmas is resisting the partnership, arguing that the medical aid provider is currently too financially unstable to be venturing into such projects.
Psmas is owed more than US$350 million by both government and private sector. Psmas, it emerges, has since resolved to adopt a wait-and-see approach despite being under pressure from Mupfumira.
“The Ministry wants Psmas to deal with Nssa concepts on NHIS and proposals for partnership. However, the society (Psmas) has decided to take a wait-and-see approach for now,” said a source. “Appropriate engagement and advice will be sought with a strategic view of sustainability of the partnership.”
In the concept paper for the partnership, Nssa says the tie-up with Psmas would help the social security agency to make a meaningful contribution and venture into the health delivery arena.
“Nssa as a state-owned entity mandated with the administration of social security in Zimbabwe can also play a pivotal role in the extension of healthcare coverage and improvement of quality in the health delivery system,” the documents read.
“For Nssa to make a meaningful contribution and venture in the health delivery arena, it realises the need to enter into strategic partnerships with seasoned actors in healthcare provision for the benefit of government of Zimbabwe and the Zimbabwean populace at large.
“This paper therefore explores the possibility of Nssa partnering with Psmas in the administration and provision of healthcare for Zimbabwean citizens.”
Sources said the partnership would help Nssa increase its revenues although the authority argues that the partnership would be a win-win for both institutions and the setting up of the insurance scheme will be a positive thing for Psmas.
Nssa in the documents says it identified Psmas as its partner of choice due to its extensive experience in medical aid administration spanning 86 years.
The authority revealed in the documents that government requested that Nssa works closely with the Ministry of Health and Child Care to develop principles for the NHIS.
“With Nssa only covering four of the nine branches of social security, the need for a robust national health plan becomes more imminent. Working with Psmas will not only expand the coverage of the nine contingencies of social security, as defined by the International Labour Organisation convention 102 of 1952, but will guarantee the population health financing when needed,” Nssa said.
“Partnership of Psmas and Nssa will enhance the security of Psmas members and their dependents in terms of health insurance as it will ensure that health insurance will be run from a social insurance perspective which fosters risk pooling , equitable access to health care services regardless of whether one civil servant or in the private sector.”
Asked to comment on the matter, Mupfumira said Nssa and Psmas were locked in negotiations, but referred questions to Nssa.
“There are discussions taking place for a collaboration of Nssa and Psmas on two different things including the setting up of NHIS but at this point I do not have details of the meetings and therefore the best person to talk to is Nssa,” said Mupfumira.
Nssa board chair Robin Vela said the partnership is still at conceptual level and formal discussions are yet to be done.
“Yes, I can confirm that there is a concept for Nssa to partner with Psmas but, look, we are yet to hold formal discussions and hopefully within the third quarter of the year we would have fully engaged,” said Vela.
“We chose Psmas as a partner because it is under the same stakeholder as Nssa which is the Ministry of Public Service, Labour and Social Welfare and therefore it is easier if we are under the same authority.”
Vela said the partnership will help the setting up of NHIS which would be launched before the end of the year.
Psmas communications and brand manager Arthur Choga said: “Yes, we have received a concept note from Nssa and we are looking into it while we await a full proposal. As Psmas we are all for provision of affordable quality healthcare and we believe the health of the nation is a priority.”