HARARE – Zimbabwe’s medical aid industry has mounted a robust defence of its right to own and operate healthcare facilities, warning parliament that a proposed amendment to a Medical Aid Statutory Instrument would trigger an industry collapse that ultimately harms the very citizens the reform claims to protect.
Industry players have told parliament that a proposed change to Section 14 of S.I. 330 of 2000, which seeks to prohibit medical aid societies from owning or operating healthcare service facilities could have reverse consequences.
Cimas Health Group chief operating officer Thando Kembo told MPs the proposed ban was “not about institutions” but about “access, affordability, and the rights of ordinary Zimbabweans to healthcare.”
“Operating as ‘just’ a payer would be a passive and frankly irresponsible way of stewarding our members’ hard-earned money,” Kembo said.
A joint industry briefing presented by Bonvie Medical Aid Scheme and Vivat Health Solutions, submitted through the Association of Healthcare Funders of Zimbabwe (AHFoZ), painted a stark picture of a sector already under severe strain.
Only 10 percent of Zimbabwe’s population – approximately 1.4 million people – hold formal medical aid cover, leaving an estimated 13.6 million without private healthcare access.
Average monthly contributions per member stand at between $55 and $65, the briefing noted, while claim ratios routinely exceed 90 percent and utilisation runs 50 percent above recommended levels.
Employers, who fund between 90 and 95 percent of insured members, are already resisting even sub-inflationary premium increases.
The industry argued that vertical integration – allowing medical aids to own clinics and hospitals – was not a commercial land-grab but a structural response to repeated market failure: medicine shortages, tariff inflation, and providers withdrawing from schemes during periods of economic volatility.
“It was a response to… capacity gaps, not an attempt to dominate the market,” Kembo told parliament’s portfolio committee on health on April 29.
Presenters cited international precedent, pointing to vertically integrated healthcare systems including Kaiser Permanente in the United States and Bupa in the United Kingdom as evidence that global best practice favours regulating conduct rather than imposing blanket prohibition.
The Bonvie/Vivat briefing warned of a “collapse cascade” should the reforms proceed: without medical aids’ negotiating power acting as a price floor, provider tariffs would go unchecked, subscriptions would rise, members would exit, and coverage – already at a fragile 10 percent – would shrink further.
Private sector revenues, of which medical aid members account for more than 60 percent, would collapse, triggering brain drain as practitioners left the country.
“Public hospitals absorb the fallout as the private relief valve fails,” the briefing stated.
The industry called on parliament to commission an independent impact assessment before enacting any reform, preserve medical aids’ cost-containment role across the healthcare value chain, align any changes with Zimbabwe’s constitutional guarantee of healthcare access, and engage all stakeholders – patients, employers, funders and providers – in co-designing reforms.
Kembo closed her remarks with a direct challenge to the committee: “Regulation, not prohibition, serves the public interest.”
