Calls for separation of medical insurance and health services

Health and Child Care Deputy Minister Sleiman Kwidini has urged that medical insurance be strictly separated from the provision of clinical and pharmaceutical services, warning that combining the two creates opportunities for patients to be exploited.

Speaking in response to concerns raised by private health service providers, Deputy Minister Kwidini said the Government envisions a system where insurance companies do not directly provide medical or pharmaceutical care. "It is not about a specific provider, but we envision a situation where a medical insurance company does not end up providing health services or selling pharmaceutical products," he said. "This has its own challenges that deprive patients of the right to choose a provider of their choice. We are seized with the matter and we are working on finding a solution that best serves our health system."

The call comes after the Medical and Dental Private Practitioners of Zimbabwe, led by Dr Johannes Marisa, raised concerns about practices by some local insurance companies that operate their own clinics and pharmacies. Dr Marisa's letter highlighted issues including refusal to register new service providers, unilateral reductions in tariffs, higher drug prices at affiliated pharmacies, and deregistration of practitioners for minor infractions, which he said adversely affect both providers and patients.

Managed health care, introduced in Zimbabwe by non-profit medical aid societies such as PSMAS and CIMAS, initially aimed to contain costs while providing accessible care to members. However, for-profit insurers have increasingly adopted the model, owning clinics and pharmacies and often requiring members to use these facilities for free consultations. Critics argue this creates conflicts of interest, as the profit motive may override the primary goal of patient care.

Deputy Minister Kwidini stressed that merging insurance and healthcare provision can lead to unethical practices, including restricting access to expensive but necessary treatments, tests, or specialist referrals to maximise profits. He reaffirmed the Government's commitment to ensuring that health insurance providers adhere to ethical standards that prioritise patient choice and fair compensation for service providers.

The Ministry of Health and Child Care plans to hold consultations with stakeholders in the coming weeks to discuss reforms and explore workable solutions that safeguard patient welfare while maintaining a fair and transparent healthcare system.