Zorena Jantze
A study by the Namibia Competition Commission (NaCC) has revealed that 82% of Namibians depend on public healthcare, while 18% of the population foot the bill for their health, paying over N$ 21,000 per annum on medical costs.
This is according to Dr. Petrus Mhata, a consultant who made a presentation on a study into the Namibian Private Healthcare Sector, 2000-2021.
Dr. Mhata explained that there is limited or no access to quality healthcare services for most Namibian citizens. Furthermore, he shared that 72% of doctors work in private health facilities, resulting in lower access to doctors in public facilities, and that just below 50% of registered nurses work in the private healthcare sector. There are about 890 private health facilities (according to the Nam Priv Healthcare Providers and Health Facility Census 2019).
Touching on the high cost of healthcare in the country, Dr. Mhata said that the private healthcare market in Namibia has experienced systemic cost increases over the period of 2005-2021.
“In 2005, the average beneficiary on a medical scheme spent just over N$5,395.71 annually on all medical benefits in 2001 prices. By 2021, this has increased to around N$21,449.54 per year – a 298% increase in costs. The largest chunk of cost is seen in hospitals (35%), followed by pharmaceuticals (16%), and specialists (11%),” Dr. Mhata said.
He added that in terms of cost pull and push factors, the annual medical aid fund premium increases are not significantly determined by administration fees (as this is fairly constant and contributes minimally). Dr. Mhata shared that they are mainly driven by other costs such as doctors’ costs, technology enhancements, overutilization, facilities, and medication (pharmacies).
According to competition analysis, Dr. Mhata said that the funders industry is highly concentrated (two Medical Aid Funds take up over 60% of the market), albeit with a marginal decline. The facilities market was found to be less concentrated.
He advised that the NaCC and relevant stakeholders review and investigate further the factors contributing to systemic cost increases in the provision of private healthcare in Namibia and conduct further studies to determine areas of concern that can be addressed through competition advocacy and other means.
“In 2015, NAMAF, in conjunction with nine Medical Aid Funds, took NACC to the High Court, arguing that being statutory bodies established in terms of the Medical Aid Funds Act 23 of 1995 (Medical Funds Aid Act), they are not7 subject to the Competition Act 2 of 2003 (Competition Act) because they are not ‘undertakings’ as contemplated in the Competition Act. The court ruled that NaCC has no jurisdiction over the conduct of NAMAF and MAFs. The effect is that the Commission cannot, by law, impose Section 23 of the Competition Act, which prohibits restrictive practices on the medical aid funds and on NAMAF, including issues related to establishing, publishing, and announcing NAMAF benchmark tariffs guidelines,” Dr. Mhata said.
He concluded that the Commission should amend the terms ‘undertaking’ and ‘for gain and reward’ in the Competition Act in order to restore its mandate for effectively promoting and enforcing fair competition among competitors in the medical aid funders industry.
Caption: File photo for illustrative purposes only.
