Zimbabwe is working on its own national health-care insurance scheme; equivalent to America’s “Obamacare” or UK’s NHS which will be known as The National Health Insurance Scheme (NHIS). The scheme will be administered by National Social Security Authority (NSSA) and is expected to be launched in the first quarter of 2017. Usually the way these national insurance schemes work is they are compulsory for all citizens and are funded through taxes which are paid by employees/employers as monthly earnings and corporates taxes respectively.
Zimbabwe’s NHIS is expected to provide health insurance cover to over 12 million Zimbabweans not covered by private health insurance; including the unemployed, low-income workers and vulnerable groups. The NHIS is being sponsored by the Health and Child Care and Public Service, Labour & Social Welfare ministries. From the NHIS Bill, indications are that the scheme will be funded through one or all of: new taxes, member contributions or NSSA finances (highly unlikely). Currently, only about 10 percent of Zimbabweans have medical aid cover provided by private health-care funders through member subscriptions.
One problem foreseen is; if this will be molded along the ‘compulsory’ western lines of similar schemes which are funded through taxes and member contributions; who will bear the brunt of the 90% unemployed. Unless the Cabinet is using the comical 10% unemployment figure which was released by the unreliable Zimbabwe National Statistics Agency (ZimStat); the socio-economic pyramid in Zimbabwe is currently not ideal for such an initiative. The taxes collected under the scheme will not be sufficient to cover the expenses of running the scheme and it will inevitably collapse on its own due to lack of funds.
NSSA and Government of Zimbabwe credibility problems
The other problem is, NSSA managing the scheme! NSSA has consistently made bad investment decisions, from Renaissance Bank, Interfin Bank, Tetrad Bank, Africom, pensioners are getting about $20 per month from 30 – 40 years of contributions and is currently involved in Telecel Zimbabwe squabbles. How can we expect NSSA to deliver a successful health insurance scheme? Government through PSMAS has dismally failed in that sector with the health-care funder owing more than $280 million to heath-care providers and the situation has not changed for the past 3 – 4 years. How then can we trust the same government to deliver a successful national health-care scheme?
NSSA board chair Mr Robin Vela told The Herald last week that, “We understand that principals of the Draft Bill have been taken to Cabinet to look at it and possibly approve. Our intention is to have the scheme up and running early next year when we expect to have our first beneficiaries receiving coverage. We already have experience in running schemes of the nature — owing to our experience with the Workman Compensation Trust Fund. The scheme will be the biggest in the country and most importantly the most affordable. We anticipate that the scheme will provide value added service for the benefit of our clients.”
It could be too early to tell how the NHIS Bill will come out, but the current government; plagued with corruption left right and center, might not be the right one to successfully implement such an initiative.