No Image Caption

Audit the service

Mandy Rittmann
SAPIENS WRITES:

Psemas is not a medical aid under Namaf. It is a subsidised voluntary benefit, open to civil servants as a perk!

Present membership is plus minus 3 000 000 with a subsidy of plus minus N$3 billion per annum. The member contribution is N$120/N$60 per month, for standard benefits and N$240/N$120 per month for higher option (private hospitals), for members and dependants, respectively.

This contribution has been fixed since 2013/14, despite >10% medical inflation. There is no sliding scale from clerk to minister!

The benefits paid out are up to 50 percent discounted from the 2024 Namaf fees. As a result, many practices have contracted out. Members have to top up. The Prosperity Complimed top up was introduced by the private sector, but there is no coordination, cooperation between Psemas administrators and Complimed. You end up time/travel between the various offices. There is no user friendly one stop service.

Methealth Namibia Administrators (MNA) captured the outsourced claims processing tender, a decade and a half ago. This was extended four times, without open tender cycle every four years. MNA belongs to the MMI Group (Metropolitan, Momentum Insurance Group) and Zebra Holdings. The business model is so designed that everybody gets a cut (commission).

The lower fees result in conveyor belt over servicing – consultations, dispensing, tests and plenty unproductive sick leave rewards and fraud.

The pool of advisors sits in the MoF (MoHSS) the Public Service Commission, the office of the prime minister and never-ending commissions of transformation.

The latest report of over N$1,000 million fraudulent claims is a reflection of mismanagement and corruption. Psemas is following Air Namibia to a crash landing.

It is run like George Orwell’s animal farm spaza shop. There is no accountability or transparency, it is like Swiss cheese full of holes.

This model is not sustainable, it is a bottomless pit. Treasury cannot reverse it out of the ICU/mortuary.

We need re-registration of all members and dependant’s confirmation of contributions, link to Namaf and the HPCNA, as well as auditing.

There must be an active preventative maintenance of your health programme – primary health care as set out in 1990, Health Memorandum – not just for women and children, but from cradle to grave, for all.

One quarter of NA/MC members suffer from the metabolic syndrome – obesity, diabetes, hypertension, arthralgia etc. This is a sad state of affairs. Malnutrition is bad/wrong nutrition. Sugar, appetite stimulant for three hourly recharges is VAT free with no warning. VAT was cancelled as we may lose votes or health.

Apply merit, pragmatism, honesty and common sense and win for all. Audit the service. It is a partnership.

* Rubrieke, meningstukke, briewe en SMS’e deur lesers en meningvormers weerspieël nie noodwendig die siening van Republikein of Namibia Media Holdings (NMH) nie. As mediahuis onderskryf NMH die etiese kode vir Namibiese media, soos toegepas deur die Media-ombudsman.

Kommentaar

Republikein 2024-06-24

Geen kommentaar is op hierdie artikel gelaat nie

Meld asseblief aan om kommentaar te lewer

Katima Mulilo: 9° | 27° Rundu: 10° | 26° Eenhana: 13° | 28° Oshakati: 13° | 27° Ruacana: 12° | 28° Tsumeb: 12° | 24° Otjiwarongo: 9° | 22° Omaruru: 11° | 25° Windhoek: 8° | 20° Gobabis: 8° | 21° Henties Bay: 17° | 31° Wind speed: 37km/h, Wind direction: E, Low tide: 10:52, High tide: 04:51, Low Tide: 23:20, High tide: 17:25 Swakopmund: 18° | 26° Wind speed: 33km/h, Wind direction: SE, Low tide: 10:50, High tide: 04:49, Low Tide: 23:18, High tide: 17:23 Walvis Bay: 19° | 32° Wind speed: 33km/h, Wind direction: SE, Low tide: 10:50, High tide: 04:48, Low Tide: 23:18, High tide: 17:22 Rehoboth: 7° | 21° Mariental: 10° | 23° Keetmanshoop: 12° | 23° Aranos: 9° | 22° Lüderitz: 15° | 31° Ariamsvlei: 12° | 24° Oranjemund: 12° | 19° Luanda: 21° | 23° Gaborone: 10° | 22° Lubumbashi: 9° | 25° Mbabane: 10° | 21° Maseru: 6° | 17° Antananarivo: 11° | 19° Lilongwe: 12° | 25° Maputo: 17° | 26° Windhoek: 8° | 20° Cape Town: 12° | 17° Durban: 14° | 23° Johannesburg: 10° | 18° Dar es Salaam: 21° | 28° Lusaka: 11° | 23° Harare: 10° | 22° Currency: GBP to NAD 22.98 | EUR to NAD 19.46 | CNY to NAD 2.5 | USD to NAD 18.16 | DZD to NAD 0.13 | AOA to NAD 0.02 | BWP to NAD 1.3 | EGP to NAD 0.37 | KES to NAD 0.14 | NGN to NAD 0.01 | ZMW to NAD 0.7 | ZWL to NAD 0.04 | BRL to NAD 3.35 | RUB to NAD 0.21 | INR to NAD 0.22 | USD to DZD 133.92 | USD to AOA 853.63 | USD to BWP 13.53 | USD to EGP 48.27 | USD to KES 127.98 | USD to NGN 1479.51 | USD to ZAR 18.16 | USD to ZMW 25.45 | USD to ZWL 321 | Stock Exchange: JSE All Share Index Same 0 | Namibian Stock Exchange (NSX) Overall Index 1783.38 Down -0.16% | Casablanca Stock Exchange (CSE) MASI 13140.91 Up +0.02% | Egyptian Exchange (EGX) 30 Index 27062.37 Up +2.44% | Botswana Stock Exchange (BSE) DCI Same 0 | NSX: MTC 7.75 SAME | Anirep 8.99 SAME | Capricorn Investment group 17.34 SAME | FirstRand Namibia Ltd 49 DOWN 0.50% | Letshego Holdings (Namibia) Ltd 4.1 UP 2.50% | Namibia Asset Management Ltd 0.7 SAME | Namibia Breweries Ltd 31.49 UP 0.03% | Nictus Holdings - Nam 2.22 SAME | Oryx Properties Ltd 12.1 UP 1.70% | Paratus Namibia Holdings 11.99 SAME | SBN Holdings 8.45 SAME | Trustco Group Holdings Ltd 0.48 SAME | B2Gold Corporation 47.34 DOWN 1.50% | Local Index closed 677.62 UP 0.12% | Overall Index closed 1534.6 DOWN 0.05% | Osino Resources Corp 19.47 DOWN 2.41% | Commodities: Gold US$ 2 326.98/OZ UP +0.33% | Copper US$ 4.42/lb UP +0.24% | Zinc US$ 2 857.40/T DOWN -0.3% | Brent Crude Oil US$ 85.91/BBP UP +1.40% | Platinum US$ 996.16/OZ UP +1.07% Sport results: Weather: Katima Mulilo: 9° | 27° Rundu: 10° | 26° Eenhana: 13° | 28° Oshakati: 13° | 27° Ruacana: 12° | 28° Tsumeb: 12° | 24° Otjiwarongo: 9° | 22° Omaruru: 11° | 25° Windhoek: 8° | 20° Gobabis: 8° | 21° Henties Bay: 17° | 31° Wind speed: 37km/h, Wind direction: E, Low tide: 10:52, High tide: 04:51, Low Tide: 23:20, High tide: 17:25 Swakopmund: 18° | 26° Wind speed: 33km/h, Wind direction: SE, Low tide: 10:50, High tide: 04:49, Low Tide: 23:18, High tide: 17:23 Walvis Bay: 19° | 32° Wind speed: 33km/h, Wind direction: SE, Low tide: 10:50, High tide: 04:48, Low Tide: 23:18, High tide: 17:22 Rehoboth: 7° | 21° Mariental: 10° | 23° Keetmanshoop: 12° | 23° Aranos: 9° | 22° Lüderitz: 15° | 31° Ariamsvlei: 12° | 24° Oranjemund: 12° | 19° Luanda: 21° | 23° Gaborone: 10° | 22° Lubumbashi: 9° | 25° Mbabane: 10° | 21° Maseru: 6° | 17° Antananarivo: 11° | 19° Lilongwe: 12° | 25° Maputo: 17° | 26° Windhoek: 8° | 20° Cape Town: 12° | 17° Durban: 14° | 23° Johannesburg: 10° | 18° Dar es Salaam: 21° | 28° Lusaka: 11° | 23° Harare: 10° | 22° Economic Indicators: Currency: GBP to NAD 22.98 | EUR to NAD 19.46 | CNY to NAD 2.5 | USD to NAD 18.16 | DZD to NAD 0.13 | AOA to NAD 0.02 | BWP to NAD 1.3 | EGP to NAD 0.37 | KES to NAD 0.14 | NGN to NAD 0.01 | ZMW to NAD 0.7 | ZWL to NAD 0.04 | BRL to NAD 3.35 | RUB to NAD 0.21 | INR to NAD 0.22 | USD to DZD 133.92 | USD to AOA 853.63 | USD to BWP 13.53 | USD to EGP 48.27 | USD to KES 127.98 | USD to NGN 1479.51 | USD to ZAR 18.16 | USD to ZMW 25.45 | USD to ZWL 321 | Stock Exchange: JSE All Share Index Same 0 | Namibian Stock Exchange (NSX) Overall Index 1783.38 Down -0.16% | Casablanca Stock Exchange (CSE) MASI 13140.91 Up +0.02% | Egyptian Exchange (EGX) 30 Index 27062.37 Up +2.44% | Botswana Stock Exchange (BSE) DCI Same 0 | NSX: MTC 7.75 SAME | Anirep 8.99 SAME | Capricorn Investment group 17.34 SAME | FirstRand Namibia Ltd 49 DOWN 0.50% | Letshego Holdings (Namibia) Ltd 4.1 UP 2.50% | Namibia Asset Management Ltd 0.7 SAME | Namibia Breweries Ltd 31.49 UP 0.03% | Nictus Holdings - Nam 2.22 SAME | Oryx Properties Ltd 12.1 UP 1.70% | Paratus Namibia Holdings 11.99 SAME | SBN Holdings 8.45 SAME | Trustco Group Holdings Ltd 0.48 SAME | B2Gold Corporation 47.34 DOWN 1.50% | Local Index closed 677.62 UP 0.12% | Overall Index closed 1534.6 DOWN 0.05% | Osino Resources Corp 19.47 DOWN 2.41% | Commodities: Gold US$ 2 326.98/OZ UP +0.33% | Copper US$ 4.42/lb UP +0.24% | Zinc US$ 2 857.40/T DOWN -0.3% | Brent Crude Oil US$ 85.91/BBP UP +1.40% | Platinum US$ 996.16/OZ UP +1.07%