Prime Minister Elijah Ngurare has publicly expressed concerns over the national medical aid fund, suggesting that doctors and Public Service Employees Medical Aid Scheme (Psemas) insiders are colluding to overcharge the government. Ngurare stated that N$4 billion has been spent on Psemas, with a cartel seemingly working to overclaim. He promised to issue a statement in response to concerns about the alleged scheme.
This is not the first time concerns have been raised about Psemas. In April 2021, a forensic investigation identified 84 doctors as outliers in their claims, with at least N$13 million paid back by then. The Ministry of Finance claimed the investigation was concluded, but the report has not been made public. The members funding Psemas have a right to read the report, and it remains unclear if the 84 doctors and alleged insiders have been handed over to the Anti-Corruption Commission and the prosecutor general.
Paying back money does not close a case, according to the editorial. A person who returns a stolen cow still stole the cow. Former President Hage Geingob's administration investigated misuse by members and their dependants, stating that abuse had cost the government millions of dollars. The Ministry of Health and Social Services said reforms were underway, including reducing the N$3 billion allocation to Psemas.
The Ministry of Health and Social Services' then-executive director, Ben Nangombe, stated that claims were not checked properly and that some doctors claimed for treatment they never provided. Recently, Finance Minister Ericah Shafudah requested an extra N$535 million for Psemas in the midterm budget, stating that the first phase of reform was complete, with a governance council in place.
President Netumbo Nandi-Ndaitwah issued a directive requiring senior government officials and civil servants under Psemas to use public healthcare facilities starting 1 April. However, it is unclear how successful this policy change was. Psemas needs more than politicking; reform must start to fix the national pension fund once and for all.
The editorial questions whether Ngurare's statement will come with reforms, names, and charges or sit on the same shelf as the last forensic report. If not, it will be another example of the government treating symptoms by cutting benefits and topping up the budget. The current model has been assessed as fiscally unsustainable, and more needs to be done to address the issue.
The issue of Psemas reform has been ongoing for years, with various attempts to address the problem. The government must take concrete actions to fix the national medical aid fund and ensure that it is used efficiently. The members funding Psemas deserve transparency and accountability, and it is time for the government to take responsibility and implement meaningful reforms.
Key points
- Prime Minister Elijah Ngurare alleges a cartel of doctors and Psemas insiders are colluding to overcharge the government.
- A forensic investigation in 2021 identified 84 doctors as outliers in their claims, with at least N$13 million paid back.
- The current Psemas model has been assessed as fiscally unsustainable, and more reforms are needed to address the issue.
