MEDICAL aid societies, healthcare executives and employee representatives have warned Parliament that proposed amendments to Statutory Instrument 330 could trigger a healthcare affordability disaster, force pensioners out of medical aid coverage and expose ordinary Zimbabweans to crippling medical bills.
During a tense stakeholder engagements before the Parliamentary Portfolio Committee on Health and Child Care, speakers mounted a fierce defence of vertically integrated medical aid systems, arguing that medical aid-owned hospitals, clinics, pharmacies and laboratories have become the last remaining shield against catastrophic out-of-pocket healthcare costs.
Stakeholders warned that dismantling the current healthcare delivery model without a viable affordability alternative risked pushing thousands of Zimbabweans out of medical aid coverage entirely.
Institute of People Management of Zimbabwe (IPMZ) representative Tinotenda Mushapaidze said employers and HR practitioners were deeply concerned about preserving affordable healthcare access for employees.
“We need proper access to healthcare without excessive out-of-pocket costs, and this is something medical aid societies have been able to provide,” Mushapaidze told the Committee.
She narrated the case of a patient who initially sought treatment at a private hospital where a US$600 upfront payment per night was demanded before admission.
“The patient was later transferred to a facility owned by the medical aid society where they were admitted without any upfront shortfall,” she said.
“After spending three days in hospital, the total shortfall bill was only US$30. That is affordable access to healthcare delivered at the right level and with positive outcomes for the patient.”
Mushapaidze warned that removing vertically integrated healthcare structures would expose workers to unsustainable medical expenses at a time when salaries were already under severe strain.
“If we continue on this path, we can ensure that employees continue to access quality and affordable healthcare,” she said.
MASCA Medical Aid Society chief executive Doug Bramson said pensioners would be among the biggest casualties if medical aid societies were stripped of their healthcare delivery infrastructure.
Bramson said many pensioners were surviving only because they could access CIMAS clinics, pharmacies and hospitals without heavy co-payments.
“The message from pensioners was simple: ‘Please don’t let this happen, otherwise we will not be able to afford medical aid and the associated shortfalls,’” Bramson said.
“They explained that in the past they paid co-payments of US$50 to US$60 just to see a general practitioner, but now they can access CIMAS clinics, pharmacies and dentists without those co-payments.”
He warned that forcing pensioners back into fully commercial healthcare structures would leave thousands unable to access treatment.
“Even within the 8 to 10 percent of Zimbabweans covered by medical aid, pensioners are already struggling to pay contributions, let alone significant co-payments,” Bramson said.
Some stakeholders acknowledged concerns around preferred provider systems and allegations of delayed payments to independent doctors, but argued that reforms should focus on fairness and accountability rather than dismantling integrated healthcare systems altogether.
Healthcare executives defended preferred provider networks as a cost-control mechanism designed to reduce patient co-payments and improve affordability.
“The most that happens is that members are provided with a list of service providers they can use without paying a co-payment,” one healthcare executive said.
“Ultimately, however, members still choose where they want to go.”
Ultramed Health chief executive Dr Sibling Mukonoweshuro delivered one of the strongest interventions, warning that the SI 330 debate was ignoring the brutal economic realities confronting ordinary Zimbabweans.
“People simply do not have money,” Mukonoweshuro said.
He said many healthcare professionals and policymakers were disconnected from the realities facing low-income households.
“We introduced a US$5 product and people laughed at it,” he said.
“But for someone earning US$250 a month, even that contribution is already more than 10 percent of their income.”
Mukonoweshuro warned that dismantling medical aid-owned healthcare facilities would expose patients to massive upfront treatment costs running into thousands of US dollars.
“If you remove medical aid clinics and these healthcare facilities, you are left with a patient earning US$250 who somehow has to raise US$5,000 before a doctor will touch them,” he said.
He also questioned the sustainability of healthcare pricing structures in Zimbabwe.
“We must recognise that we do not live in a wealthy society that can sustain the level of fees currently being charged,” Mukonoweshuro said.
The interventions come as pressure intensifies against proposed SI 330 amendments, with stakeholders warning Parliament that weakening medical aid societies’ service delivery capacity could destabilise one of the few remaining systems still cushioning Zimbabweans from runaway healthcare costs.
Healthcare stakeholders are now urging Parliament to prioritise affordability, patient access, jobs and long-term healthcare investment before approving any changes to the law.
