ON SEPTEMBER 13, 2021, State media reported that the Zambia State Insurance Corporation (ZSIC) has recently recorded a 62% rise in gross premiums income at K103.2 million in the half year ended June 30, 2021. Times of Zambia reported that the gross premiums have grown from 67.5 million in the half year to K103.2 million this year. The report further attributed the development to the growth in the medical insurance unit. We are told that during the same period, the company recorded K45.3 million profit after tax.
Our esteemed readers and concerned citizens are raising eyebrows over this development which doesn’t seem to add up. The people who have been paying taxes to the National Health Insurance Management Authority (NHIMA) are wondering why the information that the government is giving on this matter seems to be lacking in terms of credibility and they would like us to ask some questions on their behalf.
NHIMA has not disclosed how much in total has been collected in health insurance funds between the given period of 2018 to 2021. All that has been given is just a total of the amount of K170 million that has been spent in the health sector for various members who accessed health services in various health institutions during the period under review. Why hasn’t NHIMA disclosed how much it has collected so far from people on a monthly basis? Why have they not stated for the public to know what their monthly contributions amount to so that they can make comparisons with what is being declared?
NHIMA says they pay out K10 million to health institutions every month. A simple multiplication of that figure by 36 months from 2018 to 2021, would give you an estimated figure of K360 million, which under normal circumstances should have been paid out if we go by the monthly pay out figure of K10 million kwacha which NHIMA has given. The figures they have given show that only K170 million was paid or taken to our health sector. Why is this?
According to the same statement by the Director at NHIMA, the authority has at the moment 1,100,000 registered employees or members who are currently contributing 1% of their salaries. Assuming that each member or employee contributes an average medical fund of between K80 and K100, that would give us a monthly collection estimate of between K88 million and K110 million to NHIMA per month. But we are told that NHIMA has only been paying out K 10 million per month. Does this make sense?
If the National health insurance management authority is only paying out K10 million to the various healthy institutions out of the total monthly collection, and not directly to the Ministry of Health, where does the rest of the money collected by NHIMA go? How does the insurance authority account for the surplus funds?
Our health sector has been in dire need of adequate funding and certainly the money collected by NHIMA, if well utilised, can help to uplift the standards in the health sector. But it is clear that the intention for establishing NHIMA is different from what the people were told. When the previous regime introduced NHIMA, we were told that the health medical tax to NHIMA was meant to improve the health sector in areas of upgrade and construction of new health structures, modernization of our hospitals with state of the art equipment across the country, procurement of drugs and other related medical supplies. This is not what is happening. Funding towards the above areas has unfortunately not been seen or mentioned by NHIMA and this should worry every citizen who is contributing to the authority. Our people want to find out where the excess funds collected have been invested? We now hear the funds which are supposed to be invested in the health sector are now being managed by ZSIC. Was this the plan? Something is not adding up.
The authority doesn’t seem to be saving the intended purpose of improving health care services. Arising from that diversion of funds, we have now seen ZSIC Life assurance company recording a rise in health/ medical insurance premiums resulting in a profit of K45.4 million after tax. The issue of concern is that in as much as this would be regarded as a good business move in resuscitating the operations of ZSIC Life assurance company, this arrangement with NHIMA goes against the objectives of the mandatory health policy. It is as good as misusing the NHIMA medical funds. In simple terms this is misappropriation of taxpayers money.
This is a sad development which the Minister of Health must look into as a matter or urgency. It is not long ago when the Ministry was announcing to the public that the government owes medical suppliers about K 2.2 billion. If the money realized by NHIMA was used for its intended purpose we would not be sitting on this debt today. Bally must fix this!