Unresolved disputes can end up in acrimonious relationship which may have potential to affect third parties in life.
The triad of patient care in Zimbabwe bases mainly on the service provider, the patients themselves and the health insurer who should team peacefully to deliver the best health care service.
Service providers have often pointed fingers at medical aid societies which on numerous times have shown great pomposity and bully behavior when it comes to issues of honoring claims, registering service providers and setting tariffs.
It is a pity that many people are reluctant to have medical aid cover which has seen only about 10% of the entire population being under medical aid societies.
This is an industry which is stagnant, showing no signs of growth for a long time and business strategists should have answers as to why there are no growth strategies being implemented.
Do we need to invite renowned academics and business strategists like Professor Michael Porter to prescribe for us?
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I am perturbed by the claims made by medical aid societies that they are getting into red because of fraudulent claims by service providers.
Such flippant claims deserve to be thrown into the dust bins, however, we cannot wholly deny that such things are occurring but with a very small magnitude.
Painting all service providers black because of 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 medical aid societies who blatantly refuse to pay us in time while their executives enjoy huge perks on a daily basis.
Patients wonder why their so-called gold packages are not even 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 8 August 2023, Ngezi-based doctors reported Cellmed to the Competition Tariff Commission.
The anti-competitive behavior exhibited by the same Medical Aid Society 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 monopolizing the market.
The subsequent lack of competition inhibits market dynamics, stifles innovation and compromises patient access to a wide range of specialized healthcare services.
Our hope remains with the Health Service Bill to bring closure to contentious issues which have remained dormant for a time immemorial.
An arrogant medical aid society 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 surely should not be tolerated and law enforcement agents should take all the necessary actions in order 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 ‘pashashe’.
The 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 charging shortfalls if medical aid societies would honor their payments within the stipulated time.
For long, service providers have often been taken for a ride by some errant MAS but we will stand firmly to defend our profession lest we go into irreversible extinction.
The regulator should take action against aberrant medical aid societies otherwise the cries will last forever.