Minister of Health David Parirenyatwa
By Alois Vinga
ZIMBABWE’s business community and labour have dismissed government’s proposals to establish a National Health Insurance Scheme (NHIS), saying the prevailing economic conditions were not conducive for such an initiative.
This follows a request from the Ministry of Public Service, Labour and Social Welfare for both constituencies to express their views on the scheme, due to be implemented soon.
Government is currently finalising a draft bill to create NHIS which would facilitate a universal healthcare cover for all Zimbabweans.
Only 10 percent of the country’s population is covered by some form of health insurance, while 90 percent of the nation pays cash for health care.
Government is, however, likely to hit a brick wall as employers and employees, as represented by the Employers’ Confederation of Zimbabwe (EMCOZ) and the Zimbabwe Congress of Trade Unions (ZCTU) are digging in their heels.
ZCTU general secretary, Japhet Moyo, described the scheme as unfortunate to the country’s struggling small working class population that is expected to finance its operations.
He said while its establishment was noble and in line with ILO convention 102/52, it becomes a challenge to depend on the already overtaxed workers who have gone for months without salaries and wages.
Moyo also questioned the National Social Security Authority (NSSA)’s capability to effectively manage the scheme.
“The fact that the scheme will be administered by NSSA spells doom to any prospects of deriving adequate benefits. It is common knowledge that NSSA has failed to invest employees’ funds in its mandated portfolio. To this end, millions of employees’ money has vanished after being invested in incompetent banks whose licences have since been withdrawn by the central bank,” he said.
“The state of the NSSA board leaves a lot to be desired because the directors take instructions from the government. This bars them from sharing information with employees whose funds they are collecting. They don’t even take orders from the same employees who give them money everyday, which should not be the case. There are also inadequate checks and balances of the National Health and Insurance Scheme’s accountability in the use of funds because there are no clear structures as to how the contributions will be collected and disbursed”.
The labour leader also highlighted that proper procedures should be followed before implementing the scheme.
“There is need to convene an all stakeholders’ conference to deliberate on the NHIS. Countries like Ghana did carry out research which targeted all stakeholders, the insured and uninsured, including the service providers before its establishment,” Moyo noted.
EMCOZ president, Josphat Kahwema, concurred with the labour movement, pointing out that the implementation of NHIS was “a non-starter”.
“Our position, as business, is that industry is going through a traumatic moment hence implementing the scheme now maybe untimely. We regard social health as a government responsibility as this is the case internationally. We believe that government must wait until the economy has potential to grow to over three percent per annum as such a growth rate would be compatible with the introduction of the scheme,” he said.
Kahwema also raised concern over NSSA’s record of poor management of funds as one of the factors likely to affect NHIS’s success, adding that business was operating under too much pressure to finance the scheme.
“The fact that the business community and employees, who are already burdened with other taxes, are expected to fund the National Health and Insurance Scheme makes it unfair to add the burden of the insurance scheme,” said Kahwema.
Despite the scheme being perceived as a success in Ghana and Kenya, the International Journal of Education and Research notes that health facilities in these countries are owed millions of dollars in unpaid claims due to administrative inadequacies as well as technical and human resources constraints and a host of working environmental challenges.
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