Stakeholders Back Plan to Bar Medical Aid Firms from Owning Hospitals and Clinics

Health sector stakeholders in Zimbabwe have backed a proposed amendment to Statutory Instrument 330 of 2000 that would prohibit medical aid societies from owning or operating healthcare facilities, in a move aimed at strengthening accountability and protecting patients.

The amendment, proposed by the Ministry of Health and Child Care, seeks to restrict medical aid societies to their core function of pooling funds and purchasing healthcare services on behalf of members, rather than directly providing care through clinics, pharmacies or hospitals. Supporters argue that the current arrangement creates a conflict of interest, where insurers act as both funders and service providers.

Itai Rusike, executive director of the Community Working Group on Health (CWGH), said separating these roles is critical to improving efficiency and fairness in the health system.

“They cannot be fund managers and care providers because it will be difficult for them to focus on their core business of pooling resources and purchasing services on behalf of their clients,” Rusike said.

He added that the original intention of vertical integration, reducing healthcare costs, has been undermined by abuse and market distortions.

Rusike cited cases where service providers allegedly collude, including doctors who insist that patients use specific laboratories for diagnostic tests, limiting competition and driving up costs.

“Health care is not an ordinary good, such as bread or drinks, where one can choose either to consume or not,” he said. “Sickness comes unexpectedly, and patients often have no real choice, making them vulnerable to exploitation.”

He warned that smaller medical aid societies are being crowded out of the market, while uninsured or underinsured patients are often charged higher fees to compensate for reduced client volumes.

A Harare-based doctor, who declined to be named, supported the proposed reforms, comparing the current system to a football league regulator owning one of the competing teams.

“The current situation is not proper because there are no checks and balances,” the doctor said. “If you are the insurer, you are covering medical risk you cannot also be the service provider. Who then guarantees value or determines quality?”

The doctor argued that medical aid societies should focus on financing and quality assurance to ensure that members receive appropriate care from independent providers.

“It becomes daylight robbery for beneficiaries if this is not addressed,” the doctor said. “If left unchecked, more players will enter the market, set up their own facilities, and potentially offer substandard services.”

The proposed amendment has also reignited debate over the need for a comprehensive national health financing model. Rusike said the situation points to the urgency of establishing a National Health Insurance Scheme to ensure equitable access to care.

Health policy experts say separating insurance from service provision is a common regulatory approach in many countries, designed to prevent conflicts of interest and promote transparency. If adopted, the amendment could significantly reshape Zimbabwe’s private healthcare landscape, forcing medical aid societies to divest from clinical operations while strengthening oversight of service providers. Authorities say the reforms are aimed at improving patient outcomes, enhancing competition, and ensuring that healthcare delivery remains focused on quality rather than profit-driven practices.

Zimbabwe medical aid reform