LUSAKA, March 6 (Xinhua) -- Plans by the Zambian government to introduce a compulsory National Health Insurance Scheme has received mixed reactions from stakeholders, with critics saying it was another burden on the over-taxed citizens.
While the government has insisted that it will not back down in its resolve to introduce the scheme, critics have said it should be withdrawn to allow for more consultations.
The scheme will result in citizens from 18 years to 69 contributing towards the financing of health services.
The introduction of the scheme has gathered momentum, with the Health Insurance Bill passing through the second reading in parliament.
Minister of Health Chitalu Chilufya says a comprehensive consultative process by government has revealed that the majority of Zambians have supported the scheme.
In a ministerial statement released in parliament, he said the government embarked on a six-year consultative process in 2012 to get views from stakeholders on the scheme which included research and study tours to ascertain the best way of implementing it.
According to him, the establishment of the scheme will mitigate the need for people to pay from their pockets each time they were sick, adding that studies revealed that it was feasible to implement the scheme in Zambia.
"However, the study shows that an exclusive scheme cannot stand on its own, and the decision, therefore, is to have a comprehensive single pool system to cover all Zambians," he said.
"The intent is to attain equity of access, cost-effective and quality health services as close to the family as possible," he added.
In its plan, the government will also provide subsidies to cover citizens who will be unable to contribute towards the scheme.
But the decision seems to have sparked sharp reactions from a cross section of society.
On March 1, lawmakers from the main opposition United Party for National Development (UPND) walked out of parliament when the National Health Insurance Bill was introduced for the second reading.
Garry Nkombo, the opposition party's chief whip told reporters outside parliament that the government wanted to over-tax citizens after failing to secure a financing deal with the International Monetary Fund (IMF).
"We would like to tie this particular tax to the government's failure to reach a deal with the IMF- they have failed to get the money they wanted from the IMF and they now want to mop up the money from the already over-taxed Zambians," he said.
And after the Bill was presented for the second reading, other opposition lawmakers pressed the executive to withdraw it and subject it to more consultations.
"In the form that this Bill has been presented, it's not desirable that it proceeds. For me I would even propose that probably we must even consider withdrawing it now," Ephraim Belemu, a lawmaker from the main opposition said.
For Nason Msoni, leader of the opposition All People's Congress party said the idea of a health scheme was doomed to fail as it has been tried and failed.
"In the past, citizens paid for these schemes but ended up with no medicines at the end of the treatment process. Citizens are sick and tired of criminally sponsored schemes using subsidiary legislation to legitimize theft and plunder of public resources," he said.
However, Chibamba Kanyama, a local economist while welcoming the idea of a health scheme, believes that it should not be introduced now because citizens were not in a position to absorb all the various taxes and levies within a short time.
According to him, the government should wait for the economy to start registering a healthy growth rate of more than 7 percent or introduce it in 2023 in order to give citizens a five-year window for preparations.
"In addition, government needs its own window to seal existing loopholes of financial abuse to public funds as shown by the Auditor General. The pilfered and mismanaged funds come from the existing taxes. There has to be evidence that the taxes already paid by citizens are properly managed," he said.
However, stakeholders in the health sector seem to have welcomed the idea saying it was a progressive idea which needs the support of everyone.
Aaron Mujajati, Registrar of the Health Professions Council of Zambia, said the council has received the idea with excitement because it will improve on the already existing financing mechanisms for health.
On the other hand, three public health sector unions have also embraced the scheme but have called for all the lacunas to be reconciled before the bill was enacted into law.
The Zambia Union of Nurses Organization, Health Workers Union of Zambia and the Zambia National Union of Health Workers however said in a joint statement that an independent fund manager should be appointed to manage the scheme.
"We feel that Ministry of Health should focus more on delivering quality health care providers than managing the scheme. We need to involve someone independent," the statement said.
