Doctors, pharmacists back Govt push to curb medical aid monopolies

Source: Doctors, pharmacists back Govt push to curb medical aid monopolies – herald

Trust Freddy

Zimpapers Correspondent

THE medical fraternity has thrown its weight behind a Government proposal to amend health regulations to prohibit medical aid societies from owning healthcare facilities, a move aimed at curbing monopolistic tendencies and protecting patient rights.

The proposed amendments to Statutory Instrument 330 of 2000 and Section 14A of the Medical Services Bill seek to prohibit medical aid societies from owning healthcare facilities — including clinics, pharmacies and laboratories — as part of measures to dismantle what health professionals describe as entrenched “vertical integration”.

The issue took centre stage during joint consultative meetings with Parliamentary Portfolio Committees on Health and Child Care; and Public Service, Labour and Social Welfare held on Thursday, where medical practitioners argued that the current structure allows funders to simultaneously control financing, pricing and treatment pathways, creating serious conflicts of interest.

Zimbabwe Medical Association (ZiMA) president Dr Kudzai Masinire said the organisation strongly supports the proposed reforms, describing them as necessary to protect patients and restore balance within the healthcare system.

“The Zimbabwe Medical Association is very much enthused by the proposed amendments to the Statutory Instrument,” he said.

“We believe at this point in time in the socio-economic transformation of the national development cause. There needs to be clear structural reforms that separate those who are providing healthcare insurance and those who are providing services. The vertical integration that has characterised our industry for the last two decades has created a lot of challenges for the patient,” Dr Masinire said.

“We believe these legal reforms will assist in the desired transformation that will uplift the country into an upper middle-income economy.”

There has been growing scrutiny of Zimbabwe’s private healthcare system, where patients have increasingly complained about opaque billing systems, rising shortfalls and limited freedom to choose service providers. In recent years, the Government has intensified efforts to reform the health sector, including strengthening regulation of medical aid societies and improving accountability in healthcare financing.

A health practitioner, Dr Enock Mayida, told parliamentarians that the current arrangement enables funders to direct patients towards facilities they own in pursuit of profit maximisation.

“It is important that people have the freedom and independence to choose a service provider of their choice,” Dr Mayida said.

“The funder, by also being in business and trying to maximise their profits, will try to control the charges of the services and the services accessed.”

The Pharmaceutical Society of Zimbabwe (PSZ) also raised concerns over pricing transparency and accountability.

PSZ president Mrs Vimbainashe Mukakati said independent pharmacies openly disclose the price of medicines, unlike funder-operated institutions where pricing structures are often concealed.

“We are concerned about the inherent conflict of interest where the funder is the one who decides on the therapy and is the one who decides on what is paid. There is then no transparency, there are no checks and balances in the entire system. For example, if someone walks into a pharmacy today, like there is a pharmacy down by the corner, if you walk into that pharmacy, you are able to get a price for the medicine that you want to buy. If you walk into a funder-operated institution, you will not be able to get the price, but you will be told there is no shortfall,” she said.

Radiography Association of Zimbabwe vice president Ms Precious Mhlanga said patients were increasingly being treated as “commodities” rather than vulnerable individuals requiring ethical care.

“We are in full support of its amendment because we are considering the issue of patient ethics, the issue of conflict between seeing a patient as someone who is vulnerable and also seeing the patient as someone who is a commodity.”

However, some participants cautioned against viewing the dispute solely as a conflict between funders and practitioners.

Dr Sydney Mukonoweshuro warned that the proposed changes could produce unintended consequences. He also accused some doctors of inflating fees.

“I think it should not be ‘us and them’. We should really be on one side: the providers and the society. But there is so much animosity now. A lot of the pricing happening on the doctors’ side is very emotional, and much of the behaviour on the medical aid side is very vindictive. We have to find each other.”

He also disclosed that at one point local neurosurgeons charged tariffs exceeding United States dollar rates by 60 percent, arguing that such pricing pushed funders into developing competing facilities.

Association of Healthcare Funders of Zimbabwe (AHFoZ) chief executive officer Ms Shylet Sanyanga urged the Government to involve the industry in crafting solutions.

“We believe there is a need for Government to allow the Association of Health Funders of Zimbabwe, as the industry representative, to be part of the solution. This could result in a less disruptive approach.”

Chairperson of the Parliamentary Portfolio Committee on Health and Child Care Mr Discent Bajila said the reforms were necessary to address longstanding concerns over transparency in medical pricing.

Briefing the media on behalf of the committee, Mr Thomas Muwodzeri, the Member of Parliament for Ruwa constituency, said Parliament was under pressure to resolve tensions between AHFoZ and ZiMA.

“That kind of friction will compromise the health of a patient at the end of the day,” he said.