adminOthers are singing and she dances, that is, shambling shabbily from side to side, almost being blown away by the breeze that is wafting in from the east. The wind snatches at her white garment and doek, billowing madly as if to remind the world about the heroic exploits of Christopher Columbus.
The wind-propelled white garment, which the prophet says will chase away evil spirits that are causing her illness, seems to be dancing on its own volition without a body inside it. Somehow she belongs to the snake family, performing some frighteningly feeble air-slithering acrobatics and miraculously scoring, by half mark, the description of being at least perpendicular to the bare feet-backed ground.
Then she kneels down to get “muteuro” — water to treat breast cancer! Mai Maizivei knows she has breast cancer but cannot afford chemotherapy, so the prophet is the only option.
And there are many in her predicament, who turn to traditional healers and prophets. Since they cannot afford medicine, they live on belief, the sublimation of all living into faith.
Centre for Health Strategies director Dr David Parirenyatwa said National Health Insurance Scheme is the way to go for Zimbabwe if the entire population is to have medical cover.
“We are fortunate that we have a thriving public and private health care system. Private health care system helps to ease the burden on the public sector. We just have to strengthen the public health sector and make sure everyone benefits from these facilities. Only 10 percent of Zimbabwe’s population is on medical aid, and these are the ones who are more financially stable. Hence this 90 percent should also be catered for.”
He said the National Health Insurance Scheme would be the panacea to the health problem in Zimbabwe.
“Health insurance schemes have been talked about for the past 10 to 15 years but nothing has come of it. It would be of great significance to Zimbabweans since everyone would contribute, and everyone would be catered for. Health is a fundamental human right and no one should be excluded because they cannot afford it,” said Dr Parirenyatwa.
The primary source of funding schemes the world over is from the national fiscus. But with the current liquidity crunch it may take years for Zimbabweans to launch NHIS.
Ministry of Health and Child Welfare Strategy and Policy Development officer, Tonderai Kadzere, said at the moment Zimbabwe was not comprehensively funding its healthcare system.
“There are five ways of health financing. The fiscus, private insurance, out of pocket, NHIS and NGOs. In Africa most countries seem to have an overreliance on NGOs. But no government is too poor to take care of the health of its own people. NHIS is the most inclusive and Zimbabwe has advanced plans to launch such a project,” said Mr Kadzere.
The current plan is to have NHIS administered by the National Social Securities Authority.
NSSA general manager Mr James Matiza said this was a Cabinet decision.
“Cabinet made the declaration that NHIS be implemented as a social security issue. But the economic challenges we had in the past decade meant that it had to be shelved. But now there is optimism that people will have more disposable income and the fiscus will be performing well, so there is talk of reviving it.
“Government is still building resources. We are just waiting for the right time to introduce the bill into the economy,” he said.
But diseases won’t wait, as is the case with Mai Maizivei.
Mr Matiza said NHIS would be implemented in phases.
“Phase 1 would target the 10 percent who are formally employed, who are around 1 million, and their dependants. We just have to determine when they can have more disposable income, taking into account the liquidity crunch.
“Phase 2 is for those outside employment. We have to work out the figures required to finance everybody. Then we will approach Government to pay a grant every year to cover people not in employment.”
He said Government had a law that the indigents should not pay in hospital, but was failing to reimburse the hospitals. However, there are concerns that most formally employed people have medical aid cover, thus those in dire need of assistance are the unemployed.
Mr Matiza said was a fallacy.
“According to Association of Health Funders of Zimbabwe only 10 percent of the formally employed people are on medical aid. Some people feel they would rather pay out of pocket when they fall sick, and this is a big mistake. NHIS would solve all these problems,” he said.
AHFoZ managing director Mrs Shylet Sanyanga said Government must ensure that all formally employed people are compelled to join medical aid schemes.
“The Government should consider the possibility of compelling all citizens with a regular income to join any medical aid society of their choice. This will ease the burden from Government and by so doing enable it to allocate the available resources towards looking after the indigent,” she said.
She said medical societies were open to anyone who could afford.
“Anyone who has a regular income and is able to contribute can become a medical aid member.”
She added that AHFoZ believes that NHIS would be of great significance to Zimbabweans.
“NHIS will enable every Zimbabwean to access healthcare, especially the vulnerable groups. As AHFoZ, we believe NHIS should be administered by a competent body which will be able to deliver its objectives,” said Mrs Sanyanga.
However, a health financing expert said that instead of NHIS to be under NSSA, and mainly financed by workers, it would be beneficial to make sure revenue is collected from everyone.
“Zimbabwe has over 90 percent unemployment rate, therefore workers alone cannot fund it. Value Added Tax would be the best solution around it. Of the 15 percent on goods purchased, NHIS could get one percent of that. That would go a long way in raising money, after all, everyone buys goods in shops and pays VAT. Since Zimra has a very efficient revenue collection system, it would then remit 1 percent to NHIS.”
He also said it would be prudent to have the NHIS as an act of parliament and the director of the scheme to have direct access to the President.
“If the President is well aware of such a scheme, then abuse is limited. Any miscreants should be dealt with strictly such that funds are released on time,” he said.
A fully-vibrant NHIS would ensure that public hospitals and clinics would have state-of-the-art equipment as all services rendered would be adequately paid for. Other countries that have universal health cover have seen significant benefits for their populace. South Korea did not wait for an economic boom to launch its health cover.
A blueprint for the South Korean health insurance system was initiated by the Health Insurance Act of December 1963, when South Korea’s real per capita GDP (RPCG) was still under US$1 600. At that time, South Korea’s RPCG was only two-thirds of that of the Philippines, and was about the same level of Mozambique, Niger, Sri Lanka, and Cameroon.
The first social insurance programme (Employee Scheme) was introduced in 1977, starting with enterprises that had more than 500 employees, and extended coverage stepwise for smaller sized firms. Social health insurance schemes for civil servants and school employees started in 1981. In 1989 the national health insurance system covering the whole population was accomplished. A remarkable improvement in infant mortality rate and life expectancy has been made over the last three decades. Successful development of NHI, however, has involved higher costs.
Canada has its own, The Canadian National Health Insurance Programme, often times referred to as, “Medicare” and is very vibrant. South Africa is also at advanced stage of launching the National Health Insurance.
Online Reporter