The Centre for Trade Policy and Development (CTPD) has described the National Health Insurance Scheme as an indirect tax on an already heavily-inundated tax base, who will be subsidizing poorer citizens.
According to the National Health Insurance Regulations, all employers are required to register their employees as members of the Scheme and to remit one per cent of every employee’s basic salary to the scheme by the 10th of every month and every employee is also required to pay one per cent of their basic salary towards the Scheme over and above the employer’s contribution.
But CTPD executive director Isaac Mwaipopo expressed concern that the contribution to the Scheme appeared to impose an added burden on employers, who had already required to provide employees with medical attention, medicines and access to medical treatment facilities under the Employment Code Act.
He noted that the Scheme, which took effect on September 20, 2019, was an added cost as some employers had private medical schemes they subscribed to.
“CTPD observes that this means all employees will effectively be contributing a total of two per cent of their basic monthly salary to the Scheme regardless of whether or not they have a private medical aid scheme that they subscribe to. The contribution appears to be an indirect tax on an already heavily-inundated tax base, who will be subsidizing poorer citizens,” Mwaipopo stated.
“The Authority is mandated to accredit healthcare providers that will be serving the members of the Scheme. The Health Professionals Council of Zambia (HPCZ), currently, has the responsibility of accrediting healthcare providers and facilities. This raises uncertainty as to how the NHI Authority’s accreditation will differ from the HPCZ. Will the two institutions work in parallel or will healthcare providers be required to obtain accreditation from both institutions?”
He added that the use of the funds due to be raised under the Scheme remained unclear.
“It is not clear from the NHI Act whether monies from the Fund will be specifically earmarked for improvement of public healthcare facilities, including procurement of supplies and medical equipment in order enhance overall service delivery of the public healthcare system. In addition, what are the specific insured services that will be covered under the Scheme? The efforts to create universal healthcare for all Zambians is commendable, however, the above concerns will need to be addressed to provide clarity and consistency across other pieces of legislation and among various regulators,’’ observed Mwaipopo, who called on government to provide much-needed clarity and comfort to all relevant stakeholders on the workings of the Scheme.