Just like an SOE?

COMMON SENSE WRITES:PSEMAS stands for “Public Service Medical Aid Scheme”. However, PSEMAS is not a medical aid. It is a voluntary benefit, open to civil servants.The role players of PSEMAS are the Ministry of Finance (directorate), Treasury, the Public Service Commission, the Ministry of Health and Social Services, Methealth Namibia Administrators, for outsourced claims processing under the umbrella of the Metropolitan, Momentum Insurance Group and Zebra Holdings (the SWAPO business arm), the Board of MNA, with the Trade Unions NAPWU and NANTU, and the procurement board (including many additional stakeholders).MNA has performed the admin function since 2005, despite a four-year tender/procurement board cycle of free market. The contract is locked in, captured.The benefits (Standard and Higher Option) are 85% subsidized at an “agreed” discount tariff to service suppliers on contract. Membership fees have been fixed since 2013/14, despite inflation. Is this for votes?A clerk and a Minister pay the same contribution – there is no sliding scale. However, Ministers and VIP’s, Honourables, get preferential treatment and benefits. They are more equal like in George Orwell’s Animal Farm.PSEMAS does not fall under NAMAF control, like real medical aid funds; top management of MNA are not registered with the Health Professions Council of Namibia (HPCNA – to guide the profession and protect the public). There is no annual open and clinical / financial audit of services provided.MNA does not provide significant guidance of promotion of health, prevention of disease, restoration and screening (Primary Health Care Manifesto of 1990). There is no onus on members to change bad lifestyle habits to contribute to reduced health care costs and increased productivity.The gap between what PSEMAS pays out and the standard NAMAF fee is widening. This gap is expensive and unaffordable for many members.PSEMAS has about 300 000 members and a N$3 billion benefit budget, but every year treasury has to top up the claims overdraft, like an SOE.During the Covid-19 pandemic, less than fifty percent of civil servants were persuaded to be vaccinated. The costs of treatment in private hospitals in 2021/22 were exorbitant. Burials peaked in July 2021. The stress was physical, emotional and financial.With the low fees, service suppliers resorted to over-servicing to make up for losses. Short conveyor belt consultations, excessive laboratory tests and over-dispensing.The present PSEMAS service model is not viable or sustainable. GRN has realised this and appointed a Consultant Review Committee to meet this challenge.Why rediscover the wheel? GRN can continue their subsidy by offering various medical aid options, which fall under NAMAF.If PSEMAS and NIPAM work well, health and service delivery will improve – healthy, competent, friendly civil servants.

Just like an SOE?

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Republikein 2025-04-18

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Just like an SOE?

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Republikein 2025-04-18

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