Audit the service
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.
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.
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