The Government has said medical insurance should be separated from healthcare services, warning that allowing insurers to also run clinics and pharmacies creates room for patients to be exploited.

Health and Child Care Deputy Minister Sleiman Kwidini said the move is aimed at ensuring fairness and protecting patients’ rights to choose their preferred healthcare provider.

“It is not about a specific provider, but we envision a situation where a medical insurance company does not end up providing health services or selling pharmaceutical products,” said Deputy Minister Kwidini. “We are seized with the matter and we are working on finding a solution that best serves our health system.”

His comments followed concerns raised by health service providers about some insurance companies that both finance patient care and run their own facilities. Critics say this practice creates a conflict of interest, with companies likely to prioritise profit instead of patient welfare.

In a letter addressed to the Deputy Minister, the president of the Medical and Dental Private Practitioners of Zimbabwe, Dr Johannes Marisa, outlined what he described as “unethical and unfair practices” by certain insurance companies. He said the situation has affected both service providers and patients.

Key issues raised in the letter include refusal by some insurers to register new service providers, unilateral cuts in medical tariffs, and higher drug prices at insurer-owned pharmacies compared to independent pharmacies. Dr Marisa also claimed that many practitioners have been deregistered for minor infractions, making it more difficult for patients to access care.

Managed health care in Zimbabwe initially emerged from non-profit medical aid societies seeking to control costs by running their own doctors, clinics, and pharmacies. The largest societies, PSMAS and CIMAS, adopted the model, with PSMAS taking it further to limit the cost of member subscriptions. The practice was later taken up by some for-profit insurance companies, which now run their own centres and often require members to seek treatment only at their facilities.

Deputy Minister Kwidini acknowledged the concerns raised and said the Government is committed to ensuring ethical standards in the sector. “We are actively working to ensure that all health insurance providers adhere to ethical standards that prioritise patient choice and fair compensation for service providers,” he said.

The Ministry of Health and Child Care is expected to begin consultations with stakeholders in the coming weeks to discuss the matter further and consider possible reforms.

Critics warn that when insurers both fund and provide care, they may restrict expensive but necessary treatments to reduce costs. They also say patients can be steered towards insurer-owned facilities, limiting choice and potentially lowering the quality of care.

Comments

Leave a comment