GERMANY has the world’s oldest national health insurance scheme with origins dating back to Otto Von Bismarck’s Sickness Insurance Law of 1883.
Britain created the National Health Service in 1948, funded out of general taxation rather than on an insurance basis and providing health services to all legal residents.
In essence, the National Health Insurance programmes differ in how the contributions are collected and how the services are provided. In countries such as Canada, payment is made by the government directly from tax revenue and this is known as single-payer healthcare. In France, a similar system of compulsory contributions is made, but the collection is administered by non-profit organisations set up for the purpose.
The National Health Insurance Scheme seeks to ensure that health services are accessible to all citizens in line with section 76 of the Constitution which stipulates that every citizen and permanent resident of Zimbabwe has the right to have access to basic healthcare services.
A functional National Health Insurance Scheme aims to provide healthcare coverage for all citizens, ensuring that individuals and families have access to necessary medical services, regardless of their income levels, and socio-economic statuses. Financial protection of individuals is offered by reducing out-of-pocket expenses for healthcare services.
Health and Child Care minister, Dr Douglas Mombeshora, recently announced that the National Health Insurance scheme would be operational beginning July 2024.
The success of the scheme will depend on the model adopted by our government especially taking cognisance of the funding modalities available and the administration of funds.
Is Zimbabwe going to fund the health insurance through employers and employees’ contributions?
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There are many sources of funds but in varying degrees: private, employer-employee contributions and national taxes.
If the contributions are coming from formal employment taxation, it will be a serious strain on the already-burdened formal employees and with high unemployment rate, few people are left to face the health insurance tax.
Each country can make use of its own strategies to raise the necessary funds for National Health Insurance scheme.
Considering the high rate of unemployment in Zimbabwe, I foresee a funding approach where there will be legislation for compulsory contributions through some taxes which will be introduced. The success of the national scheme will be a milestone in health service delivery.
The administration of national health insurance fund is a critical determinant of the success of the scheme.
In a country such as Zimbabwe, it will be prudent to have the fund administered by a private organisation or some selected non-profit organisations in the country.
Allowing government to administer such fund may not be the best option as many people believe that government may be overwhelmed with issues.
Premier Service Medical Aid Societies is limping today and government has been the biggest contributor of funds to the society.
Any delays in releasing the funds may result in service providers refusing to attend to patients with potential consequences of collapse of the scheme.
Corruption should never be allowed to germinate, proliferate or mature in such schemes as national health insurance.
Many people will be able to access medical services in the country with decongestion of the public health system as contracted private practitioners will offer healthcare to any citizen of the country with funds coming from the national pool. Healthy people pay for the sickest through national contributions but the end result is universal health coverage in the country.
Sound execution of national health insurance scheme will bring tangible health results.
