Cabinet has resolved and tasked the Finance and Public Enterprises Ministry to speed up the process of devising ways to bring an end to the abuse of Public Servants’ Employees Medical Aid Scheme (PSEMAS), which has cost the government millions in fraudulent activities.
The outcome of a Cabinet meeting of Tuesday, noted the progress on the outcome of the review of PSEMAS, and strongly advised the ministry under the stewardship of Iipumbu Shiimi, to devise strategies to curb the abuse of PSEMAS by members and Medical Practitioners.Â
Cabinet therefore requested that the Ministry deploys reforms such as: obtaining the financial control over the finances of the Scheme; the establishment of PSEMAS tariffs and medicine pricing model which is aligned to the market, as well as to obtain clinically appropriate medicine utilisation over.
“Cabinet directed the Ministry of Health and Social Services, in consultation with the Ministry of Finance and Public Enterprises, to engage the recognised Unions on the proposed PSEMAS membership limits for medical use before consideration and endorsement,” states the Cabinet briefings issued by the Information and Communication Technology Minister, Peya Mushelenga.
In October 2022 during the mid-term budget review, Shiimi had said the government was planning to cut the PSEMAS budget by N$1 billion for 2023/24 and 2024/25 financial years. This could have been nearly half of the more than N$2 billion that medical aid has enjoyed in eight years.
This did however not happen, as evidenced in the current 2023/24 financial year budget tabled last year by Shiimi in which PSEMAS was alloacted N$2.7 billion, while the finance ministry had an over budget of N$5.8 billion.
Over the years, the government raised concerns of abuse of the PSEMAS at the hands of members and medical practitioners, and such was costing treasury N$900 million per year through fraud and collusion.
It was further reported in 2021 during a verification process undertaken by the Ministry that the cost of the medical aid scheme continued to soar, leading to 15,000 former civil servants being slashed from the system, while 17,000 dependents were detected to have been over age, including some 32,000 members who were found not to be making a full contribution yet receiving maximum benefits.
During the 2019/2020 financial year, over 36,000 ghost PSEMAS beneficiaries were detected.
