Nammed Achieves Landmark Legal Victory, Ensuring Fair Contributions and Accessible Healthcare.

Nammed Achieves Landmark Legal Victory, Ensuring Fair Contributions and Accessible Healthcare

Nammed Achieves Landmark Legal Victory, Ensuring Fair Contributions and Accessible Healthcare. Nammed Medical Aid Fund recently achieved a historic legal victory, reinforcing its commitment towards fair contributions and accessible healthcare. The Fund successfully appealed against a declaration that would have harmfully impacted the affordability of healthcare, placing the well-being of thousands of Namibians at risk.

Challenging the Declaration.

Nammed’ s Commitment to Fairness In June 2020, the Chief Executive Officer of the Namibia Financial Institutions Supervisory Authority (NAMFISA), who also serves as the Registrar of Medical Aid Funds, issued a declaration mandating medical aids to impose equal contributions on all members within the same age group and plan, irrespective of the contrasting risk profiles that exist between members who join individually and those who join as part of employer groups. While Nammed recognizes and supports the objective to improve the healthcare system, the Fund strongly believes that implementing the declaration would be irrational and have unintended and far-reaching effects. These consequences would extend beyond Nammed and its members and have long-term implications for the entire industry. In response, Nammed noted an appeal to the NAMFISA Board of Appeal, established under Section 19 of the Namibia Financial Institutions Supervisory Authority Act of 2001, seeking to challenge the decision and address these concerns.

Impact on Employer Groups: Disproportionate Burden and Affordability Concerns.

Throughout the appeal process, Nammed highlighted the implications for employer groups, considering their better risk profiles and overall positive financial contribution to medical aid funds. The Fund stressed that the proposed changes would unjustifiably and disproportionately burden these groups financially, resulting in significant contribution increases, some as high as 37%. These increases would further compound the financial challenges already experienced by many employers who contribute to their employees' medical aid and the employees themselves. Additionally, certain employer groups would be forced to scale down their healthcare benefits or completely withdraw from their medical aid, ultimately leaving employees and their families vulnerable and unprotected.

Threat to Financial Stability: Broader Consequences of Employer Group Withdrawals

The likely withdrawal of employer groups from their medical aids due to the mentioned affordability limitations would moreover negatively impact the financial stability of medical aids. This precarious situation would lead to further contribution increases, and or scaled down benefits, exacerbating the challenges to an even greater extent. The departure of employer groups from their medical aids would therefore have prolonged negative implications for everyone involved, including employer groups themselves and individuals who are not part of those groups.

Favorable Ruling: Board of Appeal Supports Nammed

Acknowledging the likely fatal outcomes that would ensue if the declaration were enforced, the Board of Appeal issued a favorable ruling in support of Nammed, ordering the declaration be set aside in its entirety. The Board of Appeal's ruling highlights the following noteworthy findings:

·???????Nammed provided extensive and detailed evidence to substantiate its claim, which remains unopposed before the Board of Appeal, thereby demonstrating that the declaration is fundamentally flawed in its merits.

·???????Nammed presented a clear and compelling argument in support of the relief sought during the appeal process.

Nammed’ s Commitment to Fair Contributions and Accessible Healthcare.

The significance of this decision highlights Nammed’ s commitment to promoting fair contributions and accessible healthcare that prioritizes the well-being of all its members, both current and future, and ensures the long-term viability of the healthcare system. Nammed remains determined in its commitment to collaborate with industry stakeholders and authorities, working hand in hand to advocate for a healthcare system that emphasizes accessibility, affordability, and the holistic well-being of all Namibians. Through these collaborative efforts, Nammed aims to shape a healthcare landscape that is inclusive and responsive to the needs of the community it serves.