Fund for Medically Uninsured


By Wezi Tjaronda WINDHOEK The increase in demand for medical care caused by the HIV/AIDS epidemic has prompted the Namibian health care sector to come up with an innovative response that will see medical treatment offered on an uninterrupted basis. Medical aid schemes offer limited annual health care benefits for HIV/AIDS-related chronic illnesses, resulting however in depleted medical aid funds, but on Wednesday the Health is Vital Risk Equalisation Fund, that will benefit patients who earn less than N$4 500 a month and have not been covered for the past 12 months, was launched. The fund is managed by a board of trustees consisting of representatives of various medical aid schemes, medical schemes administrators, health care advisors and development partners. It is administered by My Health Administrators and underwritten by Prosperity Life. The fund, said to be the first in Africa, has two options, namely Vitality Day Care for the employed but medically uninsured, and Vitality for the medically uninsured. Among other benefits, it offers the medically uninsured health care benefits for hospitalization and daily medical expenses, including HIV/AIDS treatment. The fund is a platform where medical aid funds and employer groups can transfer the risk of HIV/AIDS, to reduce the cost impact on an individual. It is designed to cater for low/middle income employed groups who previously had no access to conventional medical aid products by offering basic general healthcare benefits to the employed but medically uninsured workforce. Fund Chairman, Gabriel Mbapaha, said the Health is Vital Risk Equalisation Fund would enable the employer to provide affordable private health care to all employees, ensure affordability and also ensure standard HIV/AIDS benefits managed through uniform health care protocols. The fund has additional benefits, which include limited loss of key human capital, to reduce health related absenteeism, increase well-being and productivity of employees and prevent the need for an employee-doubling up strategy by employees. In a situation where the majority of Namibians do not have access to private health care and medical insurance, it places a big burden on government on which 84 percent of the population depend. Due to this, and the high HIV/AIDS prevalence rate that stands at 19.7 percent of the population, many people in need of anti-retroviral treatment do not get it. Mbapaha said if the formerly employed could have access to affordable private healthcare, estimates are that the burden on the public health care facilities could be reduced from 84 percent to 40 percent. Launching the fund, Prime Minister Nahas Angula commended the intervention, which he said is a step towards addressing the twin scourges of HIV/AIDS and access to basic healthcare. He said being the first in Africa, the fund could serve as a model, which has the potential to address the challenges faced by the rest of the continent. Considering that government does not have abundant resources, Angula said efforts by the private sector to lessen the burden on the public heath system were also commendable. The initiative would, apart from ensuring health for all Namibians, also support the National Strategic Plan on HIV/AIDS by adding value to its implementation, he added. PharmAccess Foundation’s Chairperson, Jeop Lange, said to get sustainable coverage of HIV/AIDS drugs, there was need for robust drugs, scaling up medical expertise and finding sustainable financing mechanisms. The foundation started as a workplace programme in 2000 to bridge the gap by showing that it was possible to provide Highly Active Anti-Retroviral Therapy in resource poor settings. The foundation will be contributing a monthly donor subsidy towards premiums of Vitality Day Care.