By Sharon Tawuya
Harare, (New Ziana) — The Association of HealthCare Funders of Zimbabwe (AFHOZ) has lobbied Parliament to halt proposed amendments to the Medical Aid Societies Regulations, citing Constitutional and public health concerns.
Appearing before the Parliamentary Portfolio Committee on Justice, Legal and Parliamentary Affairs on Tuesday, AFHOZ board chairperson Stanford Sisiya said the proposed prohibition undermines cost containment and predictability of care for members.
“I think as AFHOZ one of the things that we were expecting is that we should not have a prohibition of services for medical aid. We want to be in that space because for us it’s an issue of cost containment and predictability of the care that is expected for our members,” he said.
Sisiya said the amendment raises fundamental questions beyond health policy, including being inconsistent with Section 134 of the Constitution..
“It raises fundamental questions of legality, constitutional compliance, delegated legislative authority, property rights, competition regulation and the proper role of Parliament in approving far-reaching changes to the legal architecture governing medical aid societies,” he said.
“The proposed amendment would prohibit medical aid societies, their subsidiaries or related entities from owning, managing, operating or holding interests in healthcare service-provider assets. It would also require affected societies to submit divestiture plans and dispose of existing interests within a prescribed period. In practical terms, the amendment would dismantle existing integrated healthcare models through which medical aid societies have invested member-funded resources in clinics, pharmacies, laboratories, hospitals and related healthcare infrastructure,” he said.
“Our central submission is that the proposed amendment should not be supported in its current form. It is vulnerable to challenge because it appears to be ultra vires the Medical Services Act, inconsistent with the limits placed on subsidiary legislation by section 134 of the Constitution, disproportionate in its interference with property and economic rights, and likely to undermine rather than promote access to affordable healthcare. If reform is required, it should proceed through primary legislation after proper parliamentary debate, evidence-based impact assessment, consultation with affected members and coordination with the Competition and Tariff Commission,” he added.
On property rights, Sisiya cited Section 71 of the Constitution, which protects the right to acquire, hold, use, transfer and dispose of property.
“A measure that compels divestiture of healthcare infrastructure, reduces available service capacity, disrupts existing care networks and risks increasing out-of-pocket costs must be carefully justified,” he said.
“These investments include shares, facilities, equipment, operating platforms and related business interests. The forced divestiture of existing interests, or a regulatory measure that renders those interests unlawful or commercially unsustainable, amounts to a serious interference with property rights,” he added.
“Such interference must be lawful, reasonable, necessary and justifiable. It must also be proportionate to a legitimate public purpose. A blanket prohibition does not distinguish between harmful conduct and beneficial integration. It simply requires structural separation regardless of the facts. That approach risks being arbitrary and disproportionate.”
Sisiya also warned that the amendment is against the public interest.
“The proposed amendment should be tested against the public interest. In the healthcare context, the relevant public-interest questions are whether the measure improves access, affordability, quality, continuity of care, system capacity and financial protection for members. On those criteria, the proposed amendment is deeply concerning. Medical aid societies entered service provision because of practical market failures, including tariff instability, shortfalls, refusal by some providers to accept medical aid cards, limited infrastructure and the need to create predictable access routes for members. Integrated facilities have served as access backstops and price stabilisers. Removing them may increase dependence on third-party providers, weaken cost containment, increase shortfalls and force higher contributions or reduced benefits.”
“We expect the committee to address even the issues to do with the constitutional aspect to say there’ll be violations in terms of property rights and also this amendment is also infringing on the issue of the Competition and Tariff Commission. We should be looking at these issues rather than the Medical Services Act,” he added.
He requested an independent legal, economic and health-system impact assessment and asked that IPEC and the CTC assess whether concerns can be addressed through targeted remedies rather than compulsory divestiture.
“We want to highlight to the committee that there is no regulation by IPAC and this amendment now is actually has fallen behind has been overtaken by events so it needs to recognize that they don’t need to amend the Medical Services Act because it was already taken care of by IPEC coming in as a regulator,” he said.
New Ziana
