Fighting fit

Baitshepi Sekgweng
STANDING FIRM: Dr Malebogo Kebabonye(L), DEFIANT: Busang remains optimistic(R)

BOMAID rubbishes talk of poorly finances

The amount BOMAID pays out to health service providers every month

BOMAID has moved swiftly to squash speculation its finances may be suffering from potentially terminal ill-health.

The wicked whispers emerged following the society’s decision to limit members to ten visits to a general practitioner and four visits to see specialists.

The move, made in July, had some pessimists fearing BOMAID may be on its deathbed.

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Confirming this was far from the truth, addressing the media at a roundtable discussion this week, BOMAID Chief Financial Officer (CFO), Galebowe Busang insisted the medical aid provider was perfectly placed to execute its mandate.

“We are not a profit making organisation, any surplus we get we reinvest it back into the fund. So for us to be able to be sustainable, we need to be careful with how we use our funds and make sure that we plough back what we make at all times,” explained Busang, adding they have ratios which indicate how BOMAID is performing and whether the fund is sustainable.

“Minimum solvency ratio [an enterprise’s ability to meet its long-term debt obligations] for Medical Aid has been set at 25 percent but for us as BOMAID in the last two quarters we have maintained a solvency ratio of over 25 percent, with Q1 at 30 percent while Q2 was 31 percent. This demonstrates that the Medical Aid is solid and has a healthy financial status and we can still sustain ourselves for the coming years,” she said.

As it stands, BOMAID is in a position to go on for four months honouring claims from members without receiving any additional subscriptions, as of the second quarter of 2023.

Every month, the fund makes a bulk payment of P100 million for all claims from its membership.

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“As the custodians of the funds we make sure that there is a balance for sustainability as well as continuing to honour claims. We are not allowed to make any other investments or take any debt, so it means the subscriptions from members are well taken care of. We make sure we do better with the little that we collect, so we are not broke but visionaries in terms of protecting funds for members and ensuring long-term existence of the fund by paying for valid claims and use money accrued for what is intended for,” continued Busang.

As it did to most enterprises, Covid-19 hit BOMAID hard, with the society suffering losses of P100 million in 2021 as it covered its members in various aspects of primary healthcare. Although things improved slightly the next year, the struggle was still very real, recording loses of P81 million.

The prognosis is much brighter for 2023, however. As of June, the fund was sitting on a surplus of P1.5 million.

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“We have managed to remain afloat for the past 53 years and we would like to add another 53 years. The scheme is turning around and we are looking forward to finishing on a surplus mode such that we plough back,” concluded Busang defiantly.

Giving a brief explanation on the ‘limited visits’ decision which originally sent the rumour-mill into overdrive, Chief Clinical Services Officer, Dr Malebogo Kebabonye said there was a good reason for this.

“Accessing general practitioners is strictly on a booking basis while a specialist is on referral and are good clinical practices. We were also looking at issues of misuse and over servicing which then harm the intended outcome of our members. So from our AGM we came with controls in place in order to guard against overuse of consultations for our members. But if it happens that a member exhausts their visits, it’s something that we can sit down with their doctor and map a way forward in terms of providing extra visits depending on the extend of the situation and our assessments,” she said, stressing the intention is not to deny care but enhance the level of relevant and appropriate care.

Established in 1970, BOMAID is the largest open medical aid fund in Botswana, providing services to 41, 712 principal members and 93, 211 beneficiaries across the country.

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