Stenzia Gumbo (45) recently got the shock of her life when she was turned away by a doctor who declined her medical aid card.
“My last payslip indicates that money is being paid so that I get treatment without having to pay cash according to my policy. But the doctor’s office told me that no contributions were being made to the society by my employer,” she said. Gumbo is now contemplating ordering her medical aid society to strike her name off its books.
In fact, many workers in Harare have found themselves in a similar predicament. It was noted in Parliament recently that medical aid societies are owed huge sums of money by many employers, including the government itself.
The situation has led to the Ministry of Health and Child Care being tasked by parliament to address what has become a standoff between doctors and medical aid societies. The ministry has since met with the two feuding parties and ordered them to solve their differences amicably without prejudicing their subscribers.
The Zimbabwe Federation of Trade Unions (ZFTU) secretary for economic affairs, Jacob Rice says it is a painful truth that money deducted by employers as contributions towards medical insurance is not being submitted to medical aid societies as intended. This has resulted in employees failing to access medical services when the need arises.
“Imagine that you confidently carry your medical aid card to a service provider only to be told that no contributions have been made in your name. We encounter such cases on a daily basis. People have lost confidence in the system and many are saying it is better to stop the deductions,” he says.
Harare News spoke to Dr Rutendo Bonde who says that as a doctor she loses out when medical aid societies don’t pay for her services. “I personally am affected by the situation where no payment is made for the offered services,” she said.
According to Rice, this has led doctors to allegedly refuse to accept medical aid in favour of cash. However, Zimbabwe Medical Aid Association (ZiMA) points out that not all doctors are refusing to accept medical aid. “From 1 July 2016 all ZiMA privately practising medical doctors will not be accepting [medical aid] from their patients until further notice. But patients who are not able to pay cash are still going to be seen and will not be left to suffer. All patients will be stabilised and referred for further comprehensive care at public health institutions” an official statement submitted by ZiMA to Harare News reads.
ZiMA added that this new stance on medical aid is meant to protect medical doctors from paying tax on funds not received, or which may never be received from medical aid societies. Current tax laws dictate that an invoice (medical aid claim form) lodged with a medical aid firm by a medical doctor is considered income received by the doctor which they must be taxed for. This tax is levied whether doctors receive payment from the medical aid society or not.
Commenting on the controversy, the Director of the Employers’ Confederation of Zimbabwe (Emcoz) John Mufukare, says employers cannot deduct money meant for medical insurance and use it otherwise. “In some cases, employers may deliberate with workers on how to allocate the available income, as cash inflows are no longer adequate. So companies are splitting or dividing proportions to use for other equally pressing issues like salaries, at the expense of medical insurance,” he said.
In Zimbabwe, joining a medical aid society is voluntary. However, due to the nature of their work, some associations in the labour market like the Engineering Iron and Steel Association of Zimbabwe (EISAZ) make it mandatory for their members’ employees to be on medical aid.
The chief executive officer of The Association of Healthcare Funders of Zimbabwe (AHFoZ), Shylet Sanyanga – whose organisation represents medical aid societies – says it is true that they are owed huge sums of money by employers who are not remitting contributions.
“Although there is no law compelling employers to put their workers on medical aid, we urge our members to continue to engage respective employer organisations in order to try and find solutions to this problem which employers say is being caused by liquidity challenges,” she said.