UNRESOLVED disputes can end up in acrimonious relationships, which may have the potential to affect third parties in life.
The triad of patient care in Zimbabwe is based mainly on the service provider, the patients themselves and the health insurer who should team up peacefully to deliver the best healthcare service.
Service providers have often pointed fingers at medical aid societies (MASes) which have on numerous occasions shown great pomposity and bully behaviour when it comes to honouring claims, registering service providers and setting tariffs.
It is a pity that many people are reluctant to have medical aid coverage which has seen only about 10% of the entire population being under MASes.
This is a stagnant industry, showing no signs of growth for a long time and business strategists should have answers as to why no growth strategies are being implemented.
Do we need to invite renowned academics and business strategists such as professor Michael Porter to prescribe solutions for us?
I am perturbed by the claims made by MASes that they are in the red because of fraudulent claims from service providers.
Such flippant claims deserve to be thrown in the dustbin.
However, we cannot wholly deny that such things are occurring, but are of a very small magnitude.
Painting all service providers black because of a few isolated cases is exasperating as we know it is mere scapegoating for not paying.
We have worked tirelessly in the country despite being sidelined by some of these MASes which blatantly refuse to pay us in time while their executives enjoy huge perks.
Patients wonder why their so-called gold packages are not accepted by some service providers and it circles around the issue of non-payment, delayed payment, or the bully behaviour exhibited by health funders.
On August 8, 2023, Ngezi-based doctors reported Cellmed to the Competition and Tariff Commission.
The anti-competitive behaviour exhibited by the MASes is not only nauseating, but piquing.
New medical practitioners who have sought to register with Ngezi Platinum Mine have been refused the chance to join the claims platform, thus effectively monopolising the market.
The subsequent lack of competition inhibits market dynamics, stifles innovation and compromises patient access to a wide range of specialised healthcare services.
Our hopes are pinned on the Health Service Bill to bring closure to contentious issues that have remained dominant for a long time.
An arrogant MAS should not attract more clients and I think it is out of ignorance that organisations sign service contracts with such.
Service providers, who are found on the wrong side of the law by falsifying claims, should face the music as we do not condone such indiscipline in the profession.
Acts of fraud should not be tolerated and law enforcement agents should take necessary action to protect the integrity of the medical profession.
It is a pity that patients are caught in the melee and they are the final losers as they experience double financial loss.
Monthly premiums have been increased significantly, the cost of healthcare has sky-rocketed and service providers end up requiring cash up-front.
As service providers, we would not be demanding payment for shortfalls if MASes honour their payments within the stipulated time.
For long, service providers have often been taken for a ride by some errant MASes, but we will stand firmly defending our profession lest we go into extinction.
The regulator should take action against aberrant MASes otherwise the acrimony will last forever.
Johannes Marisa is a medical practitioner, and president of the Medical and Dental Private Practitioners Association of Zimbabwe
