• Doctors engage BOMaid over tariffs

NOT AMUSED: Some of the medical practitioners

Botswana Medical Aid Society (BOMaid) subscribers may soon be forced to pay extra cash upfront when seeking treatment as the society engages in a tussle with medical doctors over health service tariffs.

This week disgruntled medical doctors thronged the BOMaid head office in Gaborone to submit a petition suggesting a resolution to initiate balance billing by the beginning of February.
The balance billing model of payment will require patients to pay cash on top of the limit set by the medical aid society to settle a medical bill.

Doctors also pointed out that the tariffs for private health care services are at least three times less than in other countries in the region hence have suggested an increase of 20% for 2012.
The doctors who include Medical Practitioners Group of Botswana (MPG), Botswana Dental Association (BODEA) and the Optometrists Group argue that there has been a rapid decline in earnings over the last 10-15 years due to a lack of inflationary adjustments of tariff rates, short payments, late payments and interest free credit policy with no obligation on the Medical Aid Societies (MAS) to pay. They claim that such practices and contracts with MAS have left them exposed to excessive debt and that the situation was threatening the viability of private practice in Botswana.

“It is financially irresponsible for any business to continue practicing in such a self destructive manner. A number of highly trained doctors have left the country and several more are likely to leave because of such frustrations. There are real concerns that professional standards will then decline in line with reduced rates that the MAS are offering,” the doctors stated in their petition.

Under the balance billing system where consumers will be required to settle the balance of payment, the doctors say medical aid societies will be free to set rates that they will pay for services based on their business dynamics.

“Doctors are also free to individually determine the rates they will charge for their services based on the realities of their practices. Market forces including competition among private practitioners would be allowed to influence prices,” the petition suggested.

When explaining the increase MPG Deputy Chairman, Dr Gagoitsewe Saleshando said it was kept low in order to limit out of pocket payments as long as MAS maintained their current rates. “The expectation is that there will now be real pressure for MAS to review their rates annually in line with market related forces such as inflation. Societies that fail to aid patients with improved rates for doctors will lose relevance and lose clients. Balance billing will therefore allow for real competition among medical aids, unlike the previous model of collusion and price fixing,” he said.

Last year BOMaid announced a tariff increase of 6.5%  to their contracted service providers and gave them up to January 23 to either accept the condition or be forced out of their contract and risk loss of business as patients would have to pay cash for their services. BOMaid General Manager Operations Constance Matabiswana was on Wednesday reluctant to comment on the matter for fear of pre-empting a press conference that was due for yesterday (Thursday).

“We want every media house to be represented when we give clarity on our position, so we won’t be talking to anyone until then,” she said.

Doctors at Bomaid_9261