PLAXEDES Zituta of Hatfield, Harare, recently got the shock of her life when officials at a private hospital gave her a ZW$10 000 invoice for her son’s bowel obstruction treatment.
The 12-year-old boy, Brutus, was suffering from persistent severe stomach pains and the doctors recommended surgery.
Given the realities of poor service delivery at government hospitals, Zituta made a decision to take him to a private clinic.
Though the 46-year-old had placed her son on medical aid since 2008, religiously subscribing to the scheme for the past 11 years, the medical insurance was of no use when it mattered most.
“The first thing they told me when I got to the clinic was that my son was going to need surgery. However, before they could do anything, they required ZW$10 000 as deposit for the bed and scheduled procedure. The rest of the money I would have to pay upon completion of surgery as the complexity of the procedure would determine the cost,” Zituta said.
She had to purchase drugs at a nearby pharmacy, as both the medical aid facility and the ZW$10 000 did not cover medication.
She needed ZW$660 for the drugs.
“It was so painful to realise that after 11 years of monthly subscriptions, I got little help from my medical aid. It’s pointless. I really do not know how they calculated or how much they cover, but at the end of the day it is us (subscribers) who suffer because we get very little assistance,” Zituta said.
This is a dilemma that faces many in Zimbabwe.
At a time when the average Zimbabwean is hard hit by the rising cost of basic commodities and exposed to the ruinous effects of rising inflation, affordable health services have become the tale of a bygone era.
The shortage of medicines at public hospitals has pushed people to visit private practitioners who are astonished by the realisation that the fees charged are beyond their reach.
Itai Rusike, executive director of the Community Working Group on Health (CWGH), said government must invest more in the health sector because medical services had become unreachable to the majority.
“The cost of health continues to soar and we continue to witness unnecessary deaths, deaths that are highly preventable. Instead of ‘health for all by the year 2000’, we have two decades of declining health, worsening health conditions and rising deaths especially to HIV/Aids. It is undeniable that the deplorable state of the county’s health system requires urgent attention, especially giving priority focus to revitalising the primary healthcare systems. This will go a long way in enabling every Zimbabwean equitable access to essential quality health services without facing financial difficulties,” Rusike said.
He said doctors should have a humane heart when charging for services as some physicians are inflating fees.
General practitioners’ consultation fee is ranging between ZW$100 to ZW$200 whereas physicians are demanding between ZW$1 100 and ZW$1 800 for consultation. Yet if one is on medical aid, the society only covers about ZW$200 of the amount, leaving the rest to be paid by the patient.
In April, Health minister Obadiah Moyo claimed government would establish a National Health Insurance Scheme to cushion Zimbabweans against the rapidly rising healthcare costs, but the scheme is not yet operational.
The Zimbabwe Medical Association (Zima) said some unprofessional medical aid societies are burdening patients by levying low tariffs and providing poor services.
“Medical insurance firms are mushrooming everywhere, collecting subscriptions upfront from our patients. They are top heavy and are using funds for non-member benefits (lavish lifestyles, top-of-the-range vehicles), resulting in members incurring huge shortfalls,” said Sacrifice Chirisa, the Zima secretary-general.
Association of Healthcare Funders of Zimbabwe (AHFoZ) chief executive officer Shylet Sanyanga however said the organisation is aware that people can barely afford medication.
“Healthcare is currently not affordable even for those who are employed, because of a pricing mismatch, this is worse for the unemployed,” Sanyanga said.
She further called on government to prioritise the health sector through foreign currency allocation in order to stabilise prices of medication and to revitalise state institutions to cater for everyone.
“Most of the fees being charged by healthcare providers are based on the US dollar and change daily in line with the parallel exchange rate for the US dollar. AHFoZ rates cannot be changed in line with the parallel rates as medical aid contributions come from salaries which are not being reviewed in line with the parallel rate,” Sanyanga said.
“This has created a mismatch, resulting in patients being asked to pay the difference between the AHFoZ rate and the provider’s fee which is benchmarked against the US dollar rate for the day.
“As AHFoZ, we believe that healthcare should be included under essential commodities category such as fuel, wheat and cooking oil for the ease of accessing foreign currency for provider categories such as pharmaceuticals supplies, hospitals, pathology and radiology services to avoid parallel pricing and stockouts.”
As doctors and medical aid societies engage in the blame game at a time government has turned a blind eye to the plight of the vulnerable, it is the patient who comes face-to-face with the frightening reality of pain and death.