PSEMAS not reaching the needy: WHO

16 Jul 2015 08:30am
WINDHOEK, 16 JUL (NAMPA) - Government is spending too much on the public service employee medical aid scheme (PSEMAS) despite it not reaching those who need it the most.
Speaking at the launch of the Namibia 2012/2013 Health Account Report dissemination event on Wednesday, World Health Organisation (WHO) representative to Namibia Monir Islam raised the concern that the N.dollars 1.3 billion expenditure on PSEMAS during that financial year is based on the risk of getting sick, but not on the ability to pay.
“With over half of health spending in Namibia provided by Government, the Government has demonstrated a strong commitment to health. However, going forward, it is important for the ministry to understand whether its health spending is sufficient and equitable across the population,” Islam said.
He cautioned that Government should aim to understand the extent to which there are unmet health needs or where its spending is not reaching those who need it the most – groups who are underutilising health services because of financial and other barriers to access.
Islam noted that approximately 400 000 people, or 19 per cent of Namibia’s population, are covered by some form of health insurance, either through PSEMAS or a private medical aid scheme. These funds together spend N.dollars 4 billion on health, meaning about 44 per cent of the total health expenditure goes toward paying for health care for only 19 per cent of the population.
The remaining 56 per cent of the total health expenditure is spread amongst the other 81 per cent of the population, who are informal workers, the unemployed, and other vulnerable populations.
However, Islam suggested that by comparing cost projections with health account data on past spending, Government can predict resource gaps and mobilise resources accordingly.
PSEMAS contributions are a flat rate regardless of the earnings of the employee – and this imposes a great financial burden on the poor. Furthermore, Government is highly subsidising civil servants, who tend to be wealthier than the overall population, the WHO representative said. Fifteen percent of PSEMAS’s total expenditure is covered by the premium paid by civil servants, and Government pays or subsidises 85 per cent of the total expenditure, which represents N.dollars 1.3 billion.
PSEMAS members have two options - one where the main member pays N.dollars 120 per month and dependants N.dollars 60 per month; and the other where the main member pays N.dollars 240 per month and dependants N.dollars 120 each per month.
Meanwhile, speaking at the same event, Minister of Health and Social Services Bernard Haufiku noted that Namibia has made great progress in improving the health of its citizens over the years.
“Sustainability of health financing together with universal health care become particularly important in light of the reduced donor funding to Namibia as we transition to an upper-middle income country. But we must also not overlook the fact that currently, 92 per cent of the total financing of health comes from domestic sources compared to 78 per cent in 2008/2009, which is already indicative of a trend towards greater domestic financial resources for health,” he stressed.
Compared to neighbouring countries, Namibia is not doing bad as far as Government spending on health is concerned, the minister said.
He added that Government through the ministry will therefore continue to ensure that resources allocated to healthcare services are used efficiently and cost-effectively to provide healthcare services to all Namibians.