By Admore Marambanyika

The Zimbabwe Congress of Trade Unions (ZCTU) is opposing the establishment of the proposed National Health Insurance Scheme (NHIS), arguing that workers and other stakeholders have not been adequately consulted.

Government plans to establish the NHIS saying it is aimed at protecting citizens from the effects of client directed healthcare expenses. It says the scheme aims to provide equitable, affordable and high quality healthcare to all Zimbabweans, eliminating financial barriers to healthcare access.

The ZCTU has, in the past, clashed with government over the funding of the NHIS. The ZCTU has over the years insisted that workers must not be taxed to fund the scheme; insisting that government should wholly bankroll the scheme from other revenue sources.

Speaking during the NHIS national stakeholders consultative meeting in Harare recently, Health and Child Care Permanent Secretary Aspect Maunganidze implored on the importance of mutual efforts in establishing a comprehensive and sustainable insurance scheme.

He said government would engage in a thorough and inclusive discussion about the design, implementation and sustainability of the NHIS.

“We recognise that the journey to implementing the NHIS will be complex and will require the concerted effort of all stakeholders. Your feedback, concerns and recommendations are crucial to shaping a scheme that is responsive to the needs of our people. I encourage open and constructive dialogue throughout this consultative process,” said Maunganidze.

The ZCTU said Zimbabwe needs to take a que from best practices from other countries that implemented the NHIS.   

“The establishment of a comprehensive National Health Insurance Scheme requires an adequate consultative process which unfortunately has not been done. The establishment of NSSA itself came as a result of wider consultations with our members. We are of the view that NSSA must provide the resources to the Social Partners to enable this process to be undertaken. For an all Stakeholders Conference to deliberate on the issue of NHIS. Countries like Ghana which have established the NHIS did so after a robust process led by highly grounded research data collected from all the stakeholders concerned. It becomes a challenge to milk the already overtaxed workers and citizens, who are already reeling under severe hardships to fund the initiative. Communities need to be educated on the concept of risk pooling and the benefits of being members of the NHI scheme. There is a need for government to sensitize the informal sector communities about the scheme and ensure that they get some fair understanding of its modalities–mere awareness of the scheme launch is not enough. Also, household size and income are factors that require special attention when deciding on the premiums for the scheme as affordability is an important determinant of the size of the risk pool,” noted the ZCTU.

The ZCTU also said a holistic and inclusive approach has been crafted to incorporate informal sector workers for the scheme to be acceptable adding that the current process still leaves out stakeholders from consultations.

“Our view is that on sustainable financing, the NHIS should be wholly financed by the government. Employers must contribute a certain percentage towards workers’ compensation and we would like to propose that the percentage be split towards NHIS and work related injuries,” the union said.

In 2007 the ZCTU successfully resisted the implementation of the NHIS which was set to be administered under the realm of the National Social Security Authority (NSSA). Back then, the ZCTU argued that ‘the establishment of NSSA itself came as a result of wider consultations with our members’.

In 2016, the ZCTU again, resisted the NHIS until issues to do with who will run and administer the fund are thoroughly debated and agreed on by workers.

ZCTU secretary-general Japhet Moyo said the union was against the introduction of another compulsory government-administered levy, following the chaos associated with people's pensions being administered by NSSA.

Moyo said a majority of its affiliate unions have rejected the government’s planned move, saying NSSA should not be allowed to administer the health fund given its stained background of giving paltry benefits to pensioners and investing in failed banks.