AHFoZ Warns Ban on Medical Aid-Owned Clinics Could Hurt Patients

The Association of Healthcare Funders of Zimbabwe (AHFoZ) has raised fresh concerns over a proposed amendment to Statutory Instrument 330 of 2000 that would bar medical aid societies from owning or operating clinics, pharmacies and hospitals. The amendment, proposed by the Ministry of Health and Child Care, seeks to restrict medical aid providers to their core function of pooling funds and purchasing healthcare services for members, effectively separating insurance from service provision.

However, AHFoZ chief executive Shylet Sanyanga warned that an outright ban could have unintended consequences for patients.

“When we look at the ban or prohibition of medical aid societies from going into healthcare services, we believe that would be a retrogressive position. It will take away the current option that medical aid members have,” Sanyanga said.

She argued that insurer-owned facilities provide a critical fallback when private healthcare providers refuse to accept medical aid.

“If a service provider rejects their medical aid card, they have at least the option of going to their medical aid society’s units,” she said. “If those units are forced to close, patients are left at the mercy of providers who may not accept medical aid as a form of payment.”

AHFoZ maintains that medical aid-owned facilities help ease pressure on Zimbabwe’s healthcare system by expanding service availability.

“These facilities are contributing to healthcare delivery not only for members but for the broader public,” Sanyanga said.

Her comments come amid broader concerns over access, pricing, and payment delays in the private healthcare sector, where some providers reportedly demand cash payments or impose top-up fees despite patients having valid medical aid cover.

A medical aid member who spoke anonymously said banning insurer-run facilities would worsen access challenges.

“You would be told the medical aid is not accepted, and you must pay cash because insurers delay payments. Some providers even demand unnecessary top-ups,” he said.

He added that pricing inconsistencies and exchange rate distortions are already placing a heavy burden on patients.

“Healthcare pricing is unpredictable. Charges vary depending on the patient’s desperation. If you ask for local currency pricing, the cost can triple,” he said.

The policyholder said he currently pays about ZiG7,000 close to US$300, for cover for himself and his three children, describing the cost as high relative to the level of service.

While supporting reforms, some stakeholders have urged the government to adopt a more balanced approach rather than imposing a blanket ban. Farai Mahaso of the Batanai HIV and Aids Service Organisation (BHASO) suggested introducing safeguards to address conflicts of interest.

“Instead of banning medical aid societies from owning healthcare facilities, adopt conflict-of-interest safeguards such as transparent pricing and independent audits, while strengthening solvency rules and member protections,” Mahaso said.

AHFoZ is also advocating for a transition to a risk-based capital model, which would require insurers to hold sufficient reserves to cover potential claims, thereby improving financial stability in the sector.

The proposed amendment has sparked a wider debate within Zimbabwe’s health sector, with regulators seeking to improve accountability while industry players warn of reduced access to care. Health policy experts note that separating insurers from service providers is a common regulatory approach globally, aimed at reducing conflicts of interest. However, they caution that implementation must consider local realities, including existing gaps in healthcare access.

As consultations continue, the outcome of the proposed amendment is expected to significantly reshape Zimbabwe’s healthcare financing and delivery landscape, with potential implications for both providers and patients.

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