Madhana takes bids as goverment backs away from profit

National health insurance program Madhana will be privatised under a Public-Private Partnership to prevent “unwise” government control of a profitable business, said President Mohamed Nasheed.

The president said all citizens would be included in the insurance program by next January as long as Parliament passes the relevant Tax and Business Profit Tax bills.

An estimated Rf850 million will be spend on insuring the Maldives’ entire population. The government hopes to sign an agreement with Islamic Development Bank (IDB) in November, which would provide a US$258 million loan towards developing health services in Addu City, reports Haveeru.

The Madhana program will be handed over once proposals from local and foreign companies have been received and reviewed.


NSPA says Madhana won’t cover new clinic rates

National Social Protection Agency (NSPA) Director, Ibrahim Waheed, has told Haveeru that the Madhana health insurance scheme will not cover increased fees at private clinics. The government lifted control of clinic charges this week.

Earlier this week, an informed source told Minivan News that the clinic fees were likely to stay within the scope of the Madhana’s program.

NSPA reported said the Madhana program only covers the rates currently charged at hospitals and clinics. Any excess charges after the current Madhana rate will have to be paid for by the patient.

Haveeru News reports that some clinics have agreed to keep their current rates, to protect their clients. However, those clinics that want to increase their prices will be required to stop providing insurance services.

Clinics are still required to give the government a month’s notice before implementing price changes.


Market to decide cost of private clinics, cabinet rules

The Maldivian government has dropped price controls of private health clinics months after clinics raised them illegally, according to President Mohamed Nasheed’s Press Secretary, Mohamed Zuhair.

The decision, recommended by the Cabinet, was a reaction to the rising costs of medical materials and consumables.

Earlier, the Health Ministry had approved a general consultation fee of Rf 75-100 (US$5-6), with Rf 300 (US$20) as the highest fee chargeable for a specialist consultation. So-called ‘super-specialists’  could charge more than Rf 300.

On May 12, 2011, Minivan News reported that private health clinics had raised consultation charges without government permission. The cost change was allegedly an effort to balance the devaluation of the dollar exchange rate following the government’s decision in May to implement a managed float of the rufiya.

“The private sector complained that the government had too much control over their services, and after the costs rose they weren’t able to fully operate,” Zuhair told Minivan News.

Zuhair said the government expects private clinic rates to remain moderate, and said most services will be eligible under the government’s Madhana health insurance program. The government also requires changes in medical service charges to be presented to the Ministry of Health one month before taking effect.

“The Minister of Health already has a wonderful system of monitoring in place, and whenever necessary the Ministry will propose a policy change,” said Zuhair. He added that the situation was not expected to be problematic. “The quality of treatment is equal at private clinics and public hospitals,” he claimed. “Now, people don’t have much to complain about.”

A senior informed source in the Maldives health sector told Minivan News that on average, private clinics were a Maldivian’s first choice for treatment. Although the medical treatment might be the same, the atmosphere and degree of personal supervision was often better at a clinic than at a hospital, the source said.

“Cost recovery is not the objective at most hospitals, which are subsidised,” the source explained, revealing that many patient bills at state-run hospitals only cover 25-35 percent of the total service.

“When people go to a hospital to get treated, they are not usually aware of what the hospital is able to provide,” said the source. “The treatment is fine, but hospitals need to increase the quality of care because people expect it, in spite of the low fees.”

The source said he believed that the competition between private clinics would keep costs affordable: “I think it’s good for the markets to determine the rate,” he said.

The source added that large clinics were likely to keep costs within the scope of the Madhana program, in order to maintain their clientele.


NSPA expands health insurance to cover poor

The National Social Protection Agency (NSPA) has said the list of people who received Zakat (alms for the poor) last year will be added to the government’s Madhana health insurance programme, reports Haveeru.

NPSA Chairman Ibrahim Waheed said the list, which includes orphans as well, has been requested at the Islamic ministry and island offices.

Over 30,000 people are registered as eligible for Zakat funds. The list will be verified before registration with Madhana, Waheed said.

Meanwhile, the ministry of fisheries and agriculture has re-opened applications for fishermen and farmers to join Madhana.

The decision was made following a number of requests from fishermen and farmers who missed the earlier deadline, reports Voice of Maldives.

The second round of applications will be open till June, while a verified list of those who applied earlier has been sent to the National Social Protection Agency for registration.

The ministry will pay half of the annual Rf2,000 fee for farmers and fishermen.


NSPA introduces family package

The National Social Protection Agency (NSPA) has introduced a family package with a 50 per cent discount for its Madhana health insurance programme.

According to Haveeru, Ibrahim Waheed, NSPA Chairman, said the government would match the participant’s Rf1,000 if three or more people are included in the insurance scheme.

The package was introduced following complaints from the public over difficulties in paying the Rf2,000 annual charge, said Waheed.

Over 52,700 people have signed up for the Mahana health insurance policy.


Religious scholars dispute government’s healthcare scheme

The vice president of religious organisation Jamiyyath-al-Salaf, Sheikh Hassan Moosa Fikry has claimed the government’s ‘Madhana’ healthcare scheme resembles an insurance program and is against the principles of Islam.

Sheikh Hassan said that the Madhana health insurance scheme “was not a balanced system” and represented
”a loss for both the people and the government.”

He also claimed that the Madhana scheme was not organised according to the Islamic banking system.

‘Madhana’ is a scheme run by the government that provides up to Rf100,000 (US$7782) of medical treatment for members, in return for an annual fee of Rf2000 (US$155).

”For example, I pay the government Rf2000 to take part in the Madhana program, and if I do not get ill that year, wouldn’t that be a loss of Rf2000 for me?” Sheikh Hassan said.

He claimed that the State Minister for Islamic Affairs Sheikh Mohamed Shaheem Ali Saeed once wrote a religious article about insurance, which on the first paragraph stated that health insurance was not allowed for Muslims.

However President of the Adhaalath Party Sheikh Hussein Rasheed Ahmed said that all health insurance programs were allowed under Islam, with the exception of self-insurance, and that Madhana was “a help” offered by the government to its people.

”I’m not saying this in response to what Salaf has said,” he added.

Religious scholar Sheik Ilyas Hussein also claimed that only self-insurance was prohibited for Muslims.

“If the Madhana health scheme was done as business then it might be a problem,” he said. “If it is done as charity it would be allowed.”

Spokesman for the Islamic Ministry Sheikh Ahmadhulla said he could not comment on the issue at the moment “because this is a religious matter” and he did not have the right to give religious advice.

Permanent secretary for the Health Ministry Sheena Moosa said that she was also unable to comment as the issue was a religious matter, but claimed the Madhana scheme was not modelled on health insurance.

”We do it as charity for the benefit of people,” she said, adding that the government did not invest any of the money received it received through the scheme.

”We keep all the money as a separate fund,” she explained.