Source: EDITORIAL COMMENT: Dump utopian ideas | The Financial Gazette December 1, 2016
LABOUR and Social Services Minister, Prisca Mupfumira, announced last week that Cabinet had approved the establishment of a National Health Insurance Scheme (NHIS) in order to enhance access to health by the generality of our population.
Zimbabwe has a population of about 14 million, of which 67 percent of the country’s citizens are in rural areas where access to healthcare is a major headache.
Of serious concern is that only 10 percent of the population is covered by some form of health insurance, while 90 percent of it pays cash for healthcare.
That alone tells you that Zimbabwe is still very far from achieving universal access to health for all its citizens.
If the truth be told, no one wants to pay cash for healthcare.
It therefore goes without saying that those who are not on health insurance cannot afford the monthly payments, either because they are not gainfully employed or that the subscriptions are too steep for them.
When disease strikes, no one — unless if it’s for religious reasons — does not want to be examined, and treated by a registered health worker:
Those who cannot afford paying cash for health services are dying in their homes, leaving behind dependants who have no one to take care of.
The proliferation of churches and herbalists suggest that the spiritual realm is now providing respite for many.
Production is suffering due to absenteeism at workplaces and deaths that could have been avoided as the nation struggles to fight diseases due to a crumbling health delivery sector.
On paper, government’s plans for a NHIS appear noble, after all who doesn’t know that a healthy nation is a productive nation.
The assumption is that the working population would contribute some form of tax or levy towards NHIS for access by those who are currently not covered by health insurance.
But who doesn’t know that access to health facilities is no longer guaranteed even for the 10 percent who are on medical aid schemes owing to the wrangling between health workers and medical aid schemes?
With unemployment in excess of 90 percent, can the few who are still in employment afford to carry the overwhelming majority?
Even if it is to be argued that the tax net shall be extended to the informal sector, has government suddenly developed the capacity to mobilise resources from this hidden economy?
For all we know, not even the Zimbabwe Revenue Authority has succeeded in taxing the informal sector.
The establishment of NHIS sounds like one of those utopian ideas that surface in the run-up to elections to hoodwink voters into believing that their government has them at heart.
Any serious administration does not waste its time living in a dream world.
What Zimbabwe requires at this juncture are workable solutions to the current economic malaise, capable of lifting the majority of the country’s population from poverty.
Once the pathetic per capita income gets to reasonable levels, Zimbabweans would not need NHIS to access healthcare.