Government has been very careless with the regulating and monitoring of administrators of medical aid schemes.
“There are currently no subordinate regulations and rules to license and monitor the Medical Aid Funds effectively. However, the Non Banking Financial Institutions Regulatory Authority (NBFIRA) is presently consulting with the industry to determine the most effective way of regulating and supervising the industry,” is a statement not good enough to be used when making reference to a multi million pula industry, which manages and administrates funds towards health care for Batswana.
Naledi Lenchwe of NBFIRA further informed the Telegraph late that, “NBFIRA is presently consulting with the Medical Aid Fund to regulate them as insurance companies under the Insurance Industry Act or to draft separate regulations and rules in order to regulate them in the current setup as Medical Aid Funds.”
Botswana has had medical aid schemes mushrooming into the economy since BOMAID in 1969, Botswana Public Officer’s Medical Aid Scheme in 1990, Pula Medical Aid in 1991 and, more recently, the Itekanele Health Services in 2005.
Despite this, NBIFIRA was only established in 2008 to oversee the licensing and regulation of all Non Banking financial institutions, including medical aids.
Prior to its inception, efforts to find out who was responsible for the licensing of medical aid schemes were futile as the Ministries of Trade and Industry, Health and Finance all claimed that they were not responsible for it and suggested that NBFIRA should be having the relevant information.
NBFIRA, however, failed to comment before the paper went to print.
“We have been informed by NBFIRA that they are going to be regulating Medical Aids and are currently in the process of coming up with regulatory framework, of which we are fully informed and a part of. Once that regulatory framework has been drafted and agreed upon, then all details will be clear on what it will entail,” said Gaone Letshwiti, the┬áCommunications Manager of the Itekanele Health Services, adding that prior to the establishment of NBFIRA the Ministry of Health was regulating them.
In a letter dated October 28th 2011 from the Department of Health Services to the Botswana Dental Authority, it was stated that, “While Medical Aid institutions deal with health-related matters, they are neither regulated by the Ministry of Health nor the Botswana Health Profession Council.”
Batswana have been pouring their hard earned money into their medical aid funds and have been vulnerable to scams and con artists who could have easily taken advantage of the loopholes in the unclear system.
The lack of a regulatory body is also apparent in the current wrangle between medical aid service providers and medical practitioners in their inability to agree on tariffs.
A regulatory body would have been in a position to act as an arbitrator in the matter protecting the interests of the public.