(Last Updated on October 25, 2015 by Editor)
ZIMBABWE – Health and Child Care Minister Dr David Parirenyatwa should return the $100 000 advance payment that was unprocedurally made to him by Premier Service Medical Aid Society (PSMAS) last year and resign from holding a public office, the society’s members and service providers have said.
While investigations by The Herald yesterday showed that capitation no longer exists in the medical insurance industry, particularly with PSMAS which is sitting on debt in excess of US$140 million, The Herald newsroom was inundated with calls from service providers and members demanding the Cabinet minister to return the money and resign.
Zimbabwe Medical Association secretary-general Dr Shingi Bopoto said some medical practitioners had gone for over three years without receiving even a cent for services rendered to PSMAS members, yet a Cabinet minister who is also apparently the regulator of medical services was getting an advance ahead of everyone else.
Dr Bopoto said ZiMA approached the Ministry of Health in February last year registering its concerns over reluctance by medical aid societies to reimburse service providers at a gazetted tariff, but to no avail.
He said two months down the line, the same regulator was given an advance by one of the medical aid societies –PSMAS — whose debts apparently constitute three quarters of unpaid claims.
“How is it possible that a medical aid that is not paying anyone is able to give an advance to the regulator? That needs to be really, really examined. So the minister is not acting because he was given an advance.”
Dr Bopoto said to date, service providers across the medical industry are owed over $200 million in unpaid claims, the majority of which are unpaid claims by PSMAS.
The advance given to Dr Parirenyatwa could have paid at least 45 general practitioners $2 000 each.
“If he is wearing his regulatory hat, he should do what the regulations require him to do. If he then goes to provide services to PSMAS members, he should claim like all of us,” said Dr Bopoto.
Zimbabwe Teachers Association (ZIMTA) chief executive officer Mr Sifiso Ndlovu slammed the minister for meddling in PSMAS affairs.
“Management and minister are conflicted. There is a conflict of interest, this must be investigated, if found to be true corrective measures must be taken,” said Mr Ndlovu.
Mr Ndlovu said Dr Parirenyatwa further compromised himself by reversing decisions made by the board.
“By redirecting actions of the board, the minister could be compromising himself further and even compromising service delivery and causing the same management team that he is protecting to be conflicted too,” said Mr Ndlovu.
Dr Parirenyatwa recently ordered PSMAS board to reinstate suspended managing director Mr Henry Mandishona facing allegations of prejudicing the society over $300 000 in a period of only four months among other allegations.
“We want a systems audit, how can a minister claim an advance from an organisation he is supposed to superintend and he gets it ahead of everybody and he sees nothing wrong with it?” said Mr Ndlovu.
He said instead of getting better, the PSMAS situation was actually deteriorating as members continue to face difficulties in accessing medical services as and when they require them.
PSMAS member Mr Rex Chikoti had no kind words for the minister either. Mr Chikoti said he got ill sometime in 2012 and was admitted at Parirenyatwa Hospital, where a bill of $12 263 accrued during a nine month period that he was sick.
“During that period I bought medicine and other sundries which were not available at the institution totalling to $4 324,” he said.
He said to date PSMAS has not paid Parirenyatwa hospital its dues and the hospital was demanding that money from him.
Adding that his application for reimbursement of the $4 324, which he used for medication that was not available at the institution was also turned down.
“Now what is coming out is really sad, that when some of us as poor as we are claimed reimbursements of what we used, we were denied but others were given money they had not worked for, not just money but huge sums of money,” he said.
A service provider who spoke on condition of anonymity and is owed over $500 000 by the society since 2013 said he entered into an agreement with PSMAS to attend to its members at a time all doctors were denying treatment to PSMAS members.
The doctor said last year, he approached the society for just $10 000 from all that he is owed but his request was turned down on the basis that the society was financially crippled.
“What surprises me now is that the same time I asked for what I was owed, another doctor was actually given an advance for services yet to be rendered,” said the doctor.
“This is really disturbing and we eagerly wait to see what happens to his case or it will end a natural death,” he said.
Another PSMAS member interviewed called for the resignation of the Minister for abusing his office, thereby disadvantaging many patients on PSMAS.
“It is very obvious the Minister abused his office and we would like to urge him to refund that money forthwith and thereafter if he could do the honorable thing and resign. Our leaders need to know that by holding a public office means they are accountable to the people and Dr Parirenyatwa has set a bad example of leadership,” she said.
Many PSMAS members are today failing to access services from preferred service providers as they are required to pay cash upfront defying the whole logic of medical insurance.
Owing to acts of mismanagement of funds by the society’s top echelon, the society has not been able to pay service providers resulting in them demanding cash upfront from PSMAS members.
Private Hospitals Association chairperson Mrs Merissa Kambani said capitation was a principle known in the medical business, but how it is applied and to who lies with the insurer.
“It is usually dependant on the relationship between the service provider and the funder,” she said.
Investigations by The Herald indicated that there used to be such an arrangement between Mars and Cimas where the two entities actually signed a contract with a fixed, pre-arranged monthly payment calculated one year in advance.
It remained fixed for that year, regardless of how often the patient needed the services.
The Zimbabwe Nurses Association (ZiNA) chairman for Harare province Mr Enock Dongo expressed disappointment with the latest revelations at PSMAS, which he said were contributing to doctors’ reluctance to accept PSMAS cards.
Mr Dongo said abuse of funds by PSMAS management and advances paid to certain individuals further crippled the institution.
“What bothers us most is the fact that monies are deducted from our pay slips every month, but we are not getting any service. “Our members are not being attended to, no doctor is accepting PSMAS cards except at Government institutions and PSMI facilities,” he said.