Masm stepping out of mandate

Medical Aid Society of Malawi (Masm), the country’s dominant provider of health insurance, is one of the household names or brands in the country.

This year, Masm is celebrating 30 years of its existence. It has been a long journey since 1984. Congratulations!

By way of definition, mutual societies refer to organisations owned by members and managed for their benefit in pursuit of a common cause which, in the case of Masm, is provision of health insurance to members (the owners). Thus, mutual society shareholders are their members who are also the customers.

Insurance refers to a cover for an eventuality. Health insurance operates more or less along the same lines as it covers members’ medical bills and until recently, in the case of Masm, funeral expenses.

The last time I checked the mandate of Masm, it remained (and still remains) a mutual society. However, technically, I note that Masm is now emphasising on profit-making and not serving members.

For example, in the past five or so years, it has become a tradition or the norm for Masm to raise premiums paid by members. Next January 1 is no exception as the society has raised the premiums by an average of 20 percent.

Masm is justifying the upward adjustment as necessary “to ensure sustainability of Masm’s activities in view of the developments in the economy in general and health sector in particular.”

Whereas it is true that inflation, interest rates and other macroeconomic variables are unstable, I find Masm’s justification to be one of those excuses inefficient organisations use to pass the cost of their inefficiencies to the poor consumers who, in our case in Malawi, love to suffer in silence.

Personally, I believe that if Masm stuck to its core business of providing health insurance, surely, members or its owners would not be paying the current rates of premiums. However, Masm chose to diversify its services, opened clinics, thereby employing more staff and increasing its operating or overhead costs. Today, Masm members’ premiums seem to go more towards paying the huge staff compliment than the service they expect to get.

Ever wondered why short-term insurance companies such as Nico General Insurance Company, UGI, Reunion and Real Insurance Company of Malawi do not own motor vehicle garages?

Initially, Masm Medi-Clinics, as the clinics are called, used to provide good service, but with time, service delivery has deteriorated and “short-falls” are the order of the day even on medicines given without paying a short-fall elsewhere.

I will not be surprised to see patients/Masm members being asked to pay for the glasses of water they take next time.

In the communication to its members about the premiums hike, Masm is asking them to ensure that their claims are correct so that Masm pays the actual amount and reduces costs.

I wonder how this will be done as Masm stopped sending members’ claim statements a long time ago. The Masm of 10 years ago used to do this, yet the Masm of the information age fails to send even electronic statements. If this is not inefficiency, then what is?

In today’s era of information and communication technology, it is also frustrating to see Masm or its agents expecting members to “memorise” their membership numbers or codes. Fine, there are membership cards, but at the mention of a member’s name, the agents should be able to, at the click of the button, search such details in the database.

Depending on the type of scheme, each Masm member is entitled to an annual claims limit. However, not all members make claims and yet, they are all subjected to high premiums every year. I look forward to the day when Masm will, as it happens in motor vehicle insurance contracts, offer “no-claim-bonus” incentives to those who either do not make a claim or do not go beyond a stated threshold. I know some will argue that health insurance is a different industry, but then, one size does not always fit all. That is where innovation comes into play, thinking outside the box.

Beyond 30 years, Masm should be more inclusive, it should stop being a club of few elites “elected” into its board at annual general meetings and executive management calling the shots. Every member is equal in mutual societies. To Masm members, current and prospective, stop suffering in silence, speak up.

Congratulations on the 30th anniversary.