Medical aid funds failing

DISGUSTED PATIENT WRITES:

Medical Aid Funds should investigate their own incompetence as the main reason for all of them facing what seem to be inevitable bankruptcy. For years they have allowed mostly foreign and politically connected doctors to literally steal the Namibian members’ money by paying out false claims by these so-called doctors and specialists. Same thing on the pharmaceutical and other disciplines’ side. No holds barred extravagant salaries, buildings etc, director’s remunerations etc, etc, etc. with you can disguise profit as running costs. Not to talk about the unqualified, drowning employees which can only fill up space. Your members have had it with you, you make them sick. I had cancer in 2023 and that moment you let me pay. The hospital and doctors as you then suddenly regarded me as the medical aid even though my plan was one of the shiniest gemstones in the envelope. Of the more than N$150 000 I paid from my own pocket you only refunded a third. You are therefore totally unreliable and cannot be trusted in times of dire need. You did not even pay a cent of the costs for my day in ICU, your excuse being that it was not pre-authorised. You let your members down and they are constantly faced with exorbitant co-payments at doctors etc, the reason being that you never adjusted your “service provider “fees in accordance with the professional standard, so nobody likes you anymore.

Then there is this sorry excuse of a self-appointed regulator called NAMAF, who has not a clue of medical costs and that suggests fees way below that of South African counterparts, and yet again the Namibian members have to pay up. Your time is up.

Your members are also mostly not informed that a fund is not there to deplete all benefits before the year ends but to cross subsidize those in need. You must educate and it is not the obligation of your “service provider”. I suggest that healthy young persons should no longer seek medical aid but instead take out a good hospital insurance policy. The money you spend on this, and in most cases also on all your day-to-day medicines, doctor’s visits, spectacles etc, will not nearly exceed the fees you pay for medical aid schemes (unless you are subsidized by your employer) and save the rest. Stop paying the bureaucrats who are just in it for the jolly ride. They have made themselves obsolete. Medical aid funds are failing.