The ever rising cost of medical bills

GABRIEL MBAPAHA, FORMER CEO OF NAMAF WRITES:

For the past decade and beyond the medical bills in Namibia have continued on an upward trajectory.

The unabated medical costs in Namibia has become a serious health risk issue due to unaffordability to ordinary members of the public. The Ministry of Finance and NAMFISA should hasten to implement the notorious Financial Institutions Bill (FIM Bill). Notwithstanding the above, there are some stipulations within the FIM Bill which need a drastic revamp in order for the bill in question to serve its intended purpose.

I am supportive of the Medical Control Board as mentioned in the bill. The envisaged role of the Medical Control Board of Namibia is to control the medical practitioners' charges. Apropos, there is sadly no legal provisions / instruments in Namibia which controls the fees of the medical practitioners.

THE MEDICAL CONTROL BOARD

In the 21st century, according to NAMAF Namibia remains one of the few countries if not the only one where the medical practitioners are allowed to charge the members at will as a norm rather than an exception. The Medical Control Board of Namibia ought to play an inextricable role of controlling the charges of the medical practitioners.

The fees of private medical practitioners, particularly medical specialists are becoming unaffordable and this is busy crippling the medical industry, hence rendering it unsustainable in medium to long term. The Government of Namibia as well as the medical aid funds are losing a lot of money to the medical practitioners in terms of medical costs/bills. The Ministry of Finance is perpetually losing even more money to the private medical practitioners because of the provision of its current subsidy system.

It is on record as to how the Ministry of Health and Social Services and the Ministry of Finance respectively should run its subsidised medical system through the mandate given to Social Security Commission to implement the Universal Healthcare Coverage (UHCAN) in Namibia.

Through a court directive in 2016 against the Namibian National Practitioners Forum (NNPF), the incumbent was forced to accept the fact that the medical aid costs were and are still unaffordable. Apropos to that there were nonetheless many doom prophets within the medical aid fraternity even in the board of trustees to say the least who stood shoulder to shoulder in favour of NNPF.

To date the medical aid funds are to an extent benefiting from the outcome of this case. It is worth mentioning at this critical juncture of our deliberations the indispensable support of Mr. Hartmut Ruppel of ENSafrica for not standing in favour with NNPF during the case in the High Court of Namibia – the same won the case in favour of the medical aid funds to the contrary. The following Government institutions: Ministry of Health and Social Services, Ministry of Finance, Social Security Fund and Motor Vehicle Accident Fund should be applauded for their unwavering support to this case.

ALL SHOULD ADHERE

Stemming from the above, the Ministry of Finance and Namibia Financial Institutions Supervisory Authority (NAMFISA) should endeavour to implement the Medical Control Board as soon as possible in order to save the public from the ever rising costs of the medical practitioners especially the medical specialists. There are medical practitioners who follow NAMAF tariffs as published every year and they should be applauded for it, but the specialists in particular do not adhere to the NAMAF tariffs at all and they unfortunately hit the pocket of ordinary citizens of this country. In addition to regular monthly medical aid fund contributions, members equally pay extra huge co-payments for medical private practitioners.

NAMAF is running an expensive exercise every year which involves actuaries to determine the tariffs which will be the yardstick of the reimbursement model which allows medical practitioners to claim from the funds. The medical aid funds and the medical practitioners including the specialists participate in this exercise but unfortunately subsequent to the publishing of the tariffs by NAMAF some of the medical practitioners and the specialists in particular do not respect the NAMAF’s tariffs as published because they charge way above the published tariffs and this unfortunately is tantamount to making the medical industry not only unaffordable but equally unsustainable.

The Ministry of Health and Social Services as the custodian of healthcare in Namibia should get involved in helping the Ministry of Finance and NAMFISA to implement the Medical Control Board or to come up with a solution to curb the ever rising medical costs of the medical practitioners in Namibia.

NAMAF in its current form cannot do much against the medical practitioners who charged above the published NAMAF’s tariffs as the NAMAF’s tariffs is only interpreted as a yardstick, hence my plea to the Ministry of Finance and NAMFISA to expedite the implementation of the Medical Control Board as the public cannot afford the medical bills of the medical practitioners anymore.