Healthcare industry highlights serious concerns at Namaf meeting
The Namibia Association of Medical Aid Funds (Namaf) faced a barrage of criticism from healthcare stakeholders on a number of issues plaguing the industry at a recent event hosted by the association.
Industry stakeholders gathered late last week to gain clarity on Namaf's organisational structure, strategies and regulatory role in promoting the private medical scheme industry.
'Blame game'
Hein Venter, managing director of Paramount Healthcare, expressed frustration over Namaf's decision to maintain 2023 tariffs without adequate consultation.
He emphasised the need for open and constructive dialogue between Namaf and healthcare providers, criticising the association's unilateral approach.
"A blame game has been exacerbated because of the inability, the inadequacy and all the miscommunications that have taken place as lately as [of] 28 November 2023. Over and above the 0% increase, the letter of November provided an expectation that providers will be communicated with in the first quarter on the results of medical funds last year and this year in the first quarter,” he said.
“Whenever we make promises, I ask that we all keep them because ultimately it is the members and patients that suffer because of the dissonance between healthcare providers and medical aid funds," he said.
He also argued that "Namaf indicated that providers wanted to be paid the maximum. That is untrue. Providers want to be paid a fair remuneration for their professional services."
Communication gaps
Meanwhile, Grace Nakalondo, a member of the Pharmacist Care Association of Namibia, raised concerns about funds paying only a fraction of claims submitted.
Meanwhile, Koos du Toit, the owner of Paramount Healthcare, pointed out the frustration of dealing with a regulator instead of directly with the funds.
"There is nowhere healthcare providers can meet collectively to discuss with the funds. Although it says that Namaf is the association of medical aid funds, it is not an association and it is not representing the funds, and I think that is where there is a level of frustration and deficiency in the structure. As a provider, you want to talk to the funds, but then you end up talking to the regulator, and that is a disjunct. Until that is solved, we will always have a communication gap," he said.
Promises made
In response, Uatavi Mbai, Namaf's spokesperson, assured stakeholders of the association's commitment to changing its communication practices.
Mbai highlighted efforts to establish a healthcare provider forum and encouraged associations to participate actively. "Allow me to assure that the old Namaf is changing its ways in terms of how we communicate. We are serious about this matter," Mbai said, acknowledging the need for better engagement with healthcare providers.
Namaf CEO Stephen Tjiuoro echoed the sentiment for reform, urging the younger generation to lead the change.
Unaffordable for most
Former health minister Dr Bernard Haufiku, in an interview with Network Media Hub, emphasised the need for improved communication and engagement to develop solutions for all parties. He also highlighted the disparity in healthcare access, stressing the importance of extending quality healthcare to the broader population.
"We spent two-three hours discussing issues that are affecting only 15% of the population. From my perspective as a former minister of health, my biggest concern is those 85% who don’t have immediate access to quality health systems," he said.
"I mean, everybody that was here has access to CT scans, MRI scans, and other technologies, easily. There is that other group that stays waiting for six months because they cannot afford to get the hip replacement that they need immediately."
Industry stakeholders gathered late last week to gain clarity on Namaf's organisational structure, strategies and regulatory role in promoting the private medical scheme industry.
'Blame game'
Hein Venter, managing director of Paramount Healthcare, expressed frustration over Namaf's decision to maintain 2023 tariffs without adequate consultation.
He emphasised the need for open and constructive dialogue between Namaf and healthcare providers, criticising the association's unilateral approach.
"A blame game has been exacerbated because of the inability, the inadequacy and all the miscommunications that have taken place as lately as [of] 28 November 2023. Over and above the 0% increase, the letter of November provided an expectation that providers will be communicated with in the first quarter on the results of medical funds last year and this year in the first quarter,” he said.
“Whenever we make promises, I ask that we all keep them because ultimately it is the members and patients that suffer because of the dissonance between healthcare providers and medical aid funds," he said.
He also argued that "Namaf indicated that providers wanted to be paid the maximum. That is untrue. Providers want to be paid a fair remuneration for their professional services."
Communication gaps
Meanwhile, Grace Nakalondo, a member of the Pharmacist Care Association of Namibia, raised concerns about funds paying only a fraction of claims submitted.
Meanwhile, Koos du Toit, the owner of Paramount Healthcare, pointed out the frustration of dealing with a regulator instead of directly with the funds.
"There is nowhere healthcare providers can meet collectively to discuss with the funds. Although it says that Namaf is the association of medical aid funds, it is not an association and it is not representing the funds, and I think that is where there is a level of frustration and deficiency in the structure. As a provider, you want to talk to the funds, but then you end up talking to the regulator, and that is a disjunct. Until that is solved, we will always have a communication gap," he said.
Promises made
In response, Uatavi Mbai, Namaf's spokesperson, assured stakeholders of the association's commitment to changing its communication practices.
Mbai highlighted efforts to establish a healthcare provider forum and encouraged associations to participate actively. "Allow me to assure that the old Namaf is changing its ways in terms of how we communicate. We are serious about this matter," Mbai said, acknowledging the need for better engagement with healthcare providers.
Namaf CEO Stephen Tjiuoro echoed the sentiment for reform, urging the younger generation to lead the change.
Unaffordable for most
Former health minister Dr Bernard Haufiku, in an interview with Network Media Hub, emphasised the need for improved communication and engagement to develop solutions for all parties. He also highlighted the disparity in healthcare access, stressing the importance of extending quality healthcare to the broader population.
"We spent two-three hours discussing issues that are affecting only 15% of the population. From my perspective as a former minister of health, my biggest concern is those 85% who don’t have immediate access to quality health systems," he said.
"I mean, everybody that was here has access to CT scans, MRI scans, and other technologies, easily. There is that other group that stays waiting for six months because they cannot afford to get the hip replacement that they need immediately."
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