Patients at risk of losing their right to privacy, forum warns
• ‘Patients pay more for less’
Despite data indicating that the rise in healthcare use in 2023 was likely temporary, the decision was made to reduce medical fund members' benefits while increasing contributions.
Henriette LamprechtWindhoek
Members of private medical aid funds may soon be asked to sign consent forms allowing their medical information to be shared.
Should they refuse, this could reportedly lead to medical claims being denied, even if the law requires payment.
Dr Jürgen Hoffmann, the CEO of the Namibia Private Practitioners Forum (NPPF), a voluntary professional body representing Namibian medical practices, referred to the Namibian Association of Medical Aid Funds (Namaf), which he said is pushing on behalf of the medical aid funds for the use of the ICD 10 medical coding system, “even though Namibia and the rest of the world have moved to ICD 11.”
According to Namaf, the decision is supported and authorised under Section 10 of the Medical Funds Act, read together with regulations 5 and 6.
“This will place patients in an impossible situation,” Hoffmann warned.
He said patients risk losing their right to reimbursement if they exercise their right to privacy. Hoffmann added that Namaf has no statutory authority to require this, as it is not a clinical regulator of providers.
Post Covid
Hoffmann also pointed to several drivers of increased healthcare use following the Covid-19 pandemic, which he said were foreseeable by 2023 but, according to him, largely ignored by Namaf’s policy decisions.
This includes the uptake of elective procedures during 2020 to 2021, a trend confirmed globally by the Altarum Health Sector Indicators and the WTW Global Medical Trends Survey.
There has also been a marked increase in registered providers since 2020, with Namaf reportedly issuing over 800 practice numbers “without a transparent, evidence-based assessment of national need or sustainability thresholds of funds,” Hoffmann said.
The NPPF also warned against “oversimplified narratives” that singled out hospitals as the main drivers of costs.
Long-term effects of chronic stress and grief
Hoffmann said support for mental health during the pandemic was “watered down”, and although tele-psychology services were approved, most funds significantly cut rates despite rising stress and trauma among the population.
He referenced several respected studies highlighting the effectiveness of tele-psychotherapy, which showed that chronic stress and grief are linked to weaker immunity, higher disease burden and increased hospitalisation.
“By reducing funding for mental healthcare when it was most needed, costs were likely shifted to later, more expensive physical illnesses that required hospitalisation,” Hoffmann explained.
He cited the World Health Organisation’s Health Atlas (2021), which confirms that mental health services – particularly in low- and middle-income countries – were among the most disrupted globally, despite growing demand.
Members deserve answers
Despite data indicating that the 2023 rise in healthcare use was likely temporary, funds, senior officials, administrators and the Namaf board of trustees reportedly decided during a strategic meeting in September 2023 to reduce members’ benefits while increasing contributions.
According to Hoffmann, the decision was made instead of addressing the well-documented root causes.
“Patients deserve answers,” he said. “They have been unfairly accused of overuse in 2023, yet they now pay more for less. Regulators must ensure that contribution increases and benefit cuts are supported by evidence. Patients’ privacy must be protected, not compromised,” Hoffmann warned.
Members’ contributions rose by 9.9% in 2024, while hospital benefits have been cut by about 33% since 2023.
In the first quarter of 2025, medical aid fund reserves strengthened, with open funds at 33.8% and closed funds at 66.5%. The industry recorded a surplus of N$229.7 million in the first quarter of this year. Namaf’s standard rate remained unchanged.
[email protected]
Members of private medical aid funds may soon be asked to sign consent forms allowing their medical information to be shared.
Should they refuse, this could reportedly lead to medical claims being denied, even if the law requires payment.
Dr Jürgen Hoffmann, the CEO of the Namibia Private Practitioners Forum (NPPF), a voluntary professional body representing Namibian medical practices, referred to the Namibian Association of Medical Aid Funds (Namaf), which he said is pushing on behalf of the medical aid funds for the use of the ICD 10 medical coding system, “even though Namibia and the rest of the world have moved to ICD 11.”
According to Namaf, the decision is supported and authorised under Section 10 of the Medical Funds Act, read together with regulations 5 and 6.
“This will place patients in an impossible situation,” Hoffmann warned.
He said patients risk losing their right to reimbursement if they exercise their right to privacy. Hoffmann added that Namaf has no statutory authority to require this, as it is not a clinical regulator of providers.
Post Covid
Hoffmann also pointed to several drivers of increased healthcare use following the Covid-19 pandemic, which he said were foreseeable by 2023 but, according to him, largely ignored by Namaf’s policy decisions.
This includes the uptake of elective procedures during 2020 to 2021, a trend confirmed globally by the Altarum Health Sector Indicators and the WTW Global Medical Trends Survey.
There has also been a marked increase in registered providers since 2020, with Namaf reportedly issuing over 800 practice numbers “without a transparent, evidence-based assessment of national need or sustainability thresholds of funds,” Hoffmann said.
The NPPF also warned against “oversimplified narratives” that singled out hospitals as the main drivers of costs.
Long-term effects of chronic stress and grief
Hoffmann said support for mental health during the pandemic was “watered down”, and although tele-psychology services were approved, most funds significantly cut rates despite rising stress and trauma among the population.
He referenced several respected studies highlighting the effectiveness of tele-psychotherapy, which showed that chronic stress and grief are linked to weaker immunity, higher disease burden and increased hospitalisation.
“By reducing funding for mental healthcare when it was most needed, costs were likely shifted to later, more expensive physical illnesses that required hospitalisation,” Hoffmann explained.
He cited the World Health Organisation’s Health Atlas (2021), which confirms that mental health services – particularly in low- and middle-income countries – were among the most disrupted globally, despite growing demand.
Members deserve answers
Despite data indicating that the 2023 rise in healthcare use was likely temporary, funds, senior officials, administrators and the Namaf board of trustees reportedly decided during a strategic meeting in September 2023 to reduce members’ benefits while increasing contributions.
According to Hoffmann, the decision was made instead of addressing the well-documented root causes.
“Patients deserve answers,” he said. “They have been unfairly accused of overuse in 2023, yet they now pay more for less. Regulators must ensure that contribution increases and benefit cuts are supported by evidence. Patients’ privacy must be protected, not compromised,” Hoffmann warned.
Members’ contributions rose by 9.9% in 2024, while hospital benefits have been cut by about 33% since 2023.
In the first quarter of 2025, medical aid fund reserves strengthened, with open funds at 33.8% and closed funds at 66.5%. The industry recorded a surplus of N$229.7 million in the first quarter of this year. Namaf’s standard rate remained unchanged.
[email protected]
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