By Edgar Brandt
WINDHOEK – The Namibia Association of Medical Aid Funds (NAMAF) yesterday said that it does not agree with the Namibian Competition Commission (NaCC), decision to take the organisation to court in a bid to declare illegal its benchmarking of tariff structures.
NAMAF chief executive officer, Gabriel Mbapaha, said all medical aid funds under NAMAF, except for Government’s Psemas, maintain that given their nature and function in the Namibian society, they are not subject to the Competition Act.
“This is an issue which the industry repeatedly raised and argued, but to no avail,” said Mbapaha adding that as long as there is no certainty about whether medical aid funds should be regulated under the Competition Act, the funds would not agree to a settlement of the codes and tariffs dispute as this would have far reaching consequences for the funds, their many members and their dependants,” argued Mbapaha.
The NaCC has indicated that it would ask the court to interdict NAMAF from “publishing tariffs, whether as guidelines, recommendations or otherwise”, as well as to interdict NAMAF members “from participating or engaging in any process whereby such tariffs are determined, recommended or implemented in a manner that infringes on the Competition Act.”
This week NaCC chief executive officer Mihe Gaomab II told New Era that NaCC remains open to further discussions with NAMAF as “it would be in the best interest of all parties concerned if this matter could be resolved amicably as the commission’s doors are open for discussions with the said parties.
“If it so happens that the courts is the only avenue parties seek to resolve this matter, the commission will state its case as required,” said Gaomab II.
However, NAMAF is adamant that the NaCC already challenged the the code and tariffs employed across the board by the Namibian health industries (both in the private and public sectors) to identify, assess and compare the costs of medical and health related goods and services.
“Medical aid funds are no exception. As statutory, non-profit organisations they depend on these codes and tariffs to determine their benefit options, long term liabilities and contribution levels at which their members must pay to sustain their funds over time. The Government also depends on these codes and tariffs and is on record in support of this important yard stick,” said Mbapaha.
He added however, that NAMAF was appreciative in respect of which the Competition Commission had now finally given notice of its intention to bring this matter to court.
“It is in the interest of not only the medical aid funds which are registered and operate in terms of the Medical Aid Funds Act, but also Psemas, the Social Security Commission, state hospitals and health facilities, the MVA Fund and all the many stakeholders who depend on a properly regulated and functioning health sector,” explained Mbapaha.
Meanwhile, the pending court case has been brought against NAMAF as the first respondent, along with Namibia Medical Care Medical Aid Fund, Namibia Health Plan Medical Aid Fund, Renaissance Health Medical Aid Fund, NAMMED Medical Aid Fund, Bankmed Medical Aid Scheme, Namdeb Medical Aid Scheme, Woermann and Brock Medical Aid Scheme, and Road Contractors Company Medical Aid Scheme.
The NaCC says it is convinced that NAMAF and its medical aid fund members are operating like a cartel by annually coming together to agree be it forehand on medical aid tariffs to charge consumers in violation of the Namibian competition laws.