The official opposition wants to know if Government is on the verge of bankruptcy and whether it is true that the cash-strapped Public Service Employees Medical Aid Scheme (PSEMAS) is struggling to pay service providers.
These are just some of the questions that DTA of Namibia’s lawmaker Nico Smit plans to ask finance minister next week in parliament.
There are currently 293 953 PSEMAS beneficiaries of which 168 969 are dependants.
Critics have long questioned the sustainability of the PSEMAS model, especially when considering the monthly contribution by members which range between N$60 and N$200.
Referring to media reports, Smit said the last payment made by PSEMAS to medical service providers was at the start of December 2016.
As a consequence many medical service providers have begun forcing PSEMAS members to settle their accounts upfront and in cash and then claim directly from PSEMAS.
Medical service providers are requiring that PSEMAS members pay upfront for treatment and medication because they in turn need to settle accounts with their suppliers, and that the delay in payment from Government is causing an untenable situation.
Smit also wants Schlettwein to reveal PSEMAS’ actual financial position.
If it is true that PSEMAS owes money to medical service providers, DTA wants to know “how much” the public medical aid scheme owes service providers and when last PSEMAS made a payment to healthcare providers.
“When was the last time that PSEMAS made payments to medical service providers for services rendered to PSEMAS members and/or their dependents and what is the number of principle members and dependents registered with PSEMAS?” questioned Smit.
Another question on DTA’s cards is whether the deductions for PSEMAS contributions were made from public service employees and from their employer.
“If yes, what is being done with this money considering claims in the abovementioned article that medical service providers are not being paid by PSEMAS?” the DTA questions.
With the above said, Smit also expects Schlettwein to answer whether “monies” deducted for PSEMAS was being used for other purposes other than that which it is intended, and if “yes” the DTA wants to know if such an act would amount to theft or fraud.
PSEMAS’ inability to pay for services rendered by medical service providers to its members has resulted into a lot of uncertainty regarding the future of private medical practitioners.
In a recent interview with The Patriot Eben De Klerk, who represents the Namibia Private Practitioners Forum said doctors were concerned that if PSEAMS can’t provide insurance for this medical practices, most of them will close down.
“I guess some (medical practitioners) will leave, some will look for alternatives or some will contemplate on working for the state. And that’s why we should not go to a point where PSEMAS says no we can’t afford you,” suggested De Klerk at the time.
Smit also want to know the economic impact on the medical service profession should it happen that PSEMAS fail to pay services rendered to it.
“What is the economic impact on the local private sector in the event that Government is unable to pay service providers for services rendered,” asks Smit.
Moreover, Smit goes on to question if PSEMAS is sustainable in its current “model”.
If it is not sustainable, Smit wants to know if there are “recommendations and/or plans, if any, developed to ensure that a more sustainable solution is put in place.”