Doctors backtrack on cash upfront demands

Zimbabwe's private doctors this week stopped demanding cash payments for services and reverted to accepting valid medical aid cards, easing the difficulties of patients struggling to afford medical attention. Private doctors had been demanding cash upfront since January, citing long delays in the processing of claims by the National Association of Medical Aid Societies (NAMAS). They also hiked their consultation fees from an average of Zim $26,500 (US $6) per visit to Zim $46,500 (US $10). Dr Billy Rigava, president of the Zimbabwe Medical Association (ZIMA), said members would now comply with an amendment to the Medical Services Act introduced by the government last week, which effectively made it a crime for any doctor to refuse services to holders of valid medical aid cards. The amendment also sought to address the doctors' complaints about delays in payment by compelling medical aid societies to pay doctors within 30 days of receiving their claims for services rendered. "We are law-abiding professionals and our role is not to make laws but to abide by them. So, with effect from [1 March], all doctors under our association shall accept medical aid cards," Rigava announced on Friday. He said one of ZIMA's conditions for reverting to the acceptance of medical aid cards was that patients requiring a general consultation at a rate of Zim $46,500 would make a cash payment of Zim $14,500 (US $3) as "co-payment", which he defined as the difference between ZIMA's own consultation fees and that of NAMAS. While ZIMA increased its consultation fees by 400 percent in November, NAMAS opted for a 360 percent rise. Doctors insist on demanding the non-refundable co-payment to make up the difference in the fee structures. "Part of the impasse between us and NAMAS was that they wanted to impose a fee structure on us - but these are the same medical aid societies that have been taking as much as three years to pay doctors for services rendered to their members. We felt this posed a serious threat to our viability," said Rigava. With ZIMA and NAMAS unable to settle their differences, the government had threatened to intervene and gazette the fees in the interests of the public.