COVID-19 overstreches medical aid industry

THE health insurance industry has been overstretched by the COVID-19 pandemic, with statistics indicating that 69% of healthcare funders have experienced a surge in cases of respiratory illnesses attributed to the global pandemic.

This was revealed yesterday by Association of Healthcare Funders of Zimbabwe (AHFoZ) chief executive officer Shylet Sanyanga. She told delegates at the 12th annual all-stakeholders' conference of healthcare funders that since the onset of the pandemic in the country in March last year, total claims expenditure increased by 12%.

"The rise in respiratory claims adversely affected about 17% of healthcare funders who had to resort to drawing from their reserves to finance claims expenditure," Sanyanga said.

"This has affected medical societies. Patients chose to defer treatment for fear of infection. Electoral procedures were deferred, while healthcare conditions considered minor were ignored. Some healthcare providers closed shop for some time for safety reasons, to assess the situation."

She said those health service providers that did not close shop experienced confusion over how to charge for COVID-19-related illnesses.

"The need for use of personal protective equipment (PPE) added an extra layer of costs. This pushed up the costs of healthcare," she said.

Statistics show that the numbers of patients seeking treatment initially decreased in the first quarter of 2020 by 21%, then increased in the second and third quarters by 23% and 22%, respectively.

During strict COVID-19-induced-lockdown periods, fewer people sought healthcare services, while there was an increase in those seeking healthcare services when lockdown restrictions were relaxed.

"As more information became available and the vaccination programme kicked off, more people presented again for treatment and the total value of claims paid collectively in 2020 was $1 724 161 406,28, while the total number of lives covered collectively by AHFoZ members for the same year was 1 672 620 lives."

She said a larger chunk paid for claims went towards medicines (23%), and in-patient services and private hospital fees which accounted for 22%.

On the positive side, Sanyanga said COVID-19 caused the healthcare sector to utilise Telehealth.

"We still anticipate the establishment of appropriate protocols by the regulator, so that Telehealth improves health outcomes rather than diminishing or compromising them," she said.

Sanyanga said Telemedicine should be utilised by the health sector without necessarily increasing costs and compromising the quality of services.

Vice-President and Health minister Constantino Chiwenga, who officiated at the conference, said efforts were being made to revamp the health sector by improving healthcare services offered by public sector facilities and re-equipping hospitals, including ambulance fleets.

Chiwenga said government would put in place an appropriate framework for public private partnerships (PPPs).

"We are aware that the lack of robust PPP frameworks has been a deterrent in the past. As we rebuild, we want to see quality services in public sector facilities and good outcomes," he said, adding that Zimbabwe should be a preferred destination for healthcare services and inbound medical tourism.