…as health ministry expresses concern
The crisis hovering over Namibia’s state medical aid system and threatening almost 300 000 vulnerable beneficiaries with no access to private healthcare creates risks that go far beyond interrupting civil servants’ access to private healthcare.
The failure of the Public Service Employees Medical Aid Scheme, which is responsible for the payment and administration of state medical aid, to act timeously has created a crisis that threatens to deliver beneficiaries on a silver platter into the hands of the public healthcare system which has often come under fire where quality is concerned.
Official statistics provided to this publication last year from NAMAF indicate that there is total of 293 953 beneficiaries who are covered under PSEMAS.
The principal members constitute 124 884 of that number while 160 618 are dependents. The remaining 8451 are pensioners.
The Ministry of Health and Social Services this week expressed concern over the ongoing PSEMAS cash crunch.
The ministry’s permanent secretary Dr. Andreas Mwoombola said the public health system stands ready to receive all patients seeking healthcare.
He is also confident that the ongoing PSEMAS crisis will not have any negative impact on the public health system.
There has been concerns expressed as to whether the public healthcare system will be able to handle an influx of patients should the PSEMAS system collapse or continue along the current trend.
Concerns have particularly been directed towards health facilities as well as personnel at hand.
“As a Ministry responsible for the provision of healthcare services we are concerned about the matter and henceforth joined the team to resolve the issue sooner,” Mwoombola said.
Years of negligence has taught Government a lesson on how to spend money meant to cover for the medical needs of civil servants, a situation which has led to a full-blown investigation by the finance and health ministries into the entire public medical aid system to close loopholes in order to minimize and eventually prevent any leakage or wastage.
Mwoombola said investigations are ongoing and “once finalized the public will be informed accordingly.”
The Patriot reported earlier this year that government paid out N$3.3 billion for private healthcare undertaken by civil servants between 2012 and 2016.
Finance minister Calle Schlettwein at the time admitted that PSEMAS is full of loopholes, but was quick to point out that remedial actions have been undertaken.
General practitioners raked in almost half of the N$3.3 billion paid by PSEMAS between 2012 and 2016.
During that period PSEMAS paid out N$1.5 billion to general practitioners, hospitals (N$1.3 billion) while N$495 million went to specialists. The total increase in benefits paid to general practitioners increased from N$282 million in 2012 to N$319 million in 2016 while that of hospitals increased by over 60% from N$129 million in 2012 to N$363 million in 2016.
As for specialists, benefits paid to them ballooned from N$58 million in 2012 to N$138 million in 2016.
Expats in the private health sector currently stand accused of overcharging patients for consultations, after hour fees for procedures, laboratory tests and medicine, a practice which many claims contributed to the PSEMAS mess.
Namibian doctors last year proposed that a national tariff setting mechanism should be put in place to replace the NAMAF recommended tariffs that are perceived to be anti-competitive.
They also want trading hours of private health facilities to be regulated so that the working hours of health professionals in such facilities do not exceed the 12 hours prescribed by the Labour Act.
Some medical doctors, mainly foreigners, are reportedly using intern doctors or nurses to run their practices in their absence and prescribe medicine outside their scope or practice without being supervised.