EDITORIAL: Psemas reform a noble idea but…

Government’s plan to compel its employees to seek treatment exclusively at public health facilities - effectively shutting the door to private hospitals for members of the Public Service Employees Medical Aid Scheme (Psemas) - raises more questions than answers.

At face value, the intention is admirable. Strengthen public healthcare. Channel resources into state facilities. Lead by example. Few would oppose the principle.

But principles do not operate hospitals - systems do.

The stated precondition for this transition was that public facilities would be upgraded to match private-sector standards. That is a tall order under the best of circumstances. With the crossover date set for 1 April, there is little evidence that government hospitals are anywhere near the promised levels of readiness.

Standards aside, capacity alone should give policymakers pause. Public hospitals are already buckling under pressure. Walk into almost any facility and you will find overcrowded wards, and patients sleeping in corridors. Now imagine adding to that mix an influx of ministers, lawmakers and executive directors - many of whom previously sought treatment at Lady Pohamba Private Hospital or Ongwediva MediClinic. The arithmetic does not inspire confidence. It forecasts congestion and chaos.

The broader concern is not the vision, but the velocity.

This administration has shown commendable boldness in its ideas. Reform is necessary. Equity in healthcare access is a legitimate national objective. But policy impatience can turn noble ambition into administrative self-sabotage.

There are still four solid years left in this term of office. Transformation does not need theatrics, but proper sequencing. Infrastructure upgrades, staffing levels and billing systems.

Then there is the unanswered financial question: what becomes of Psemas in a system where its members receive free universal healthcare? Does the employer continue contributing? Does the scheme shrink – or repurposed?