1. NAMAF TRUSTEE TRAINING 18 & 19 AUGUST 2014 FACTS & FIGURES
CHIEF EXECUTIVE OFFICER
SAFARI HOTEL WINDHOEK
NAMIBIA

2. Current NAMAF Management (MC) for 2014
Mr. Benny Amuenje – Renaissance Health (President)
Ms. Alison Begley – NMC (Vice President)
Mr. Gabriel Tjombe – Renaissance Health (Treasurer)
Mr. Gert Grobler – NAMMED: Chairperson Affordability Committee
Ms. Dolly Nashandih – NAPOTEL
Mr. Danie Louw – NMC
Ms. Glynis Labuschagne – NHP
Mr. Desley Somseb – NAMDEB: Co-opted
Ms. Elreen Austin – Woermann & Brock – Co-opted
The following Funds do not have representations on MC:
BANKMED
RCC

3. Current NAMAF Staff Compliment –2014
Mr. Gabriel Mbapaha: – Chief Executive Officer
Mr. Malakia Mateus: – Manager: Operations
Ms. Justina Nelulu: – Accountant
Ms. Rehetta Isaak: – Personal Assistant to the CEO
Ms. Ramona Mathupi: – Administrative Support Clerk
Mr. Thomas Tjituaiza: – Janitor

4. NAMAF Sub-Committees
In terms of the Medical Aid Funds Act, Act No 23 of 1995, NAMAF has the right to establish sub-committees in order to streamline its operations.
Affordability, Accessibility and Quality.
Private Public Partnership.
Capacity Building.
Regulatory and Statutory Affairs.

5. VISION
To creatively engage all stakeholders in the Namibian healthcare environment to providing families of all income/ social economic groups ongoing access to sustainable private healthcare that is comprehensive and affordable.
   

6. Mission
To be the Statutory Representative Body (Endorsed and supported by all members/stakeholders) of the Healthcare Funding Industry.
Promoting equitable, affordable, accessible qualitative and value-adding services.
To be influential in policy making for the benefit of our existing and potential members.
To facilitate open discussions and debates with all stakeholders in the Namibian Healthcare environment.
Assuring the long-term sustainability of the Namibian Healthcare Funding Industry.

7. FACTS AND FIGURES Total funds = 9 Closed Funds = 5 and
Open Funds = 4 - estimated 80% of total members.
Open Funds: NMC
- NHP
- Renaissance Health
- Nammed
Closed Funds: Bankmed
- Napotel
- RCC
- Namdeb
- Woermann & Brock

8. Membership Trends Membership (families) have increased by 5.08%
Beneficiaries have increased by 4.28%

9. Membership Trends - PSEMAS
                                                                            
Membership Trends - PSEMAS
Total               Total     Total                Ave /Dep per
      Members    Dependants      Pensioners      Members            Lives
Jan Dec 2011
95619
113902
7034
1.19
209521
Jan Dec 2012
100033
121033
6936
1.21
221066
Jan Dec 2013
103540
126708
1.22
230248
Jan 2014 –June  2014
104055
128028
1.23
232083
Total membership have increased by 3.51%
Beneficiaries have increased by 4.69%

10. Healthcare Dollar
Hospitals account for a third of the healthcare expenditure
Pharmacies and general practitioners account for about another one eighth each

11. Open and Closed Funds

12. Cost movements
Highest increases have taken place for hospitals, optometrists, medicines and “other”
“Other” is off a low base
Optometry could be due to two year cycle
Medicines could (in part) be due to change in dispensing legislation (GP costs have grown slowly)
Hospitals give cause for concern

13. Proportion of Medicines Paid
Members are faced with approximately 20% co-payments on medicines
Co-payments are similar for ethical and generic medicines

14. Generic Ratio’s
Generic ratio’s are remaining constant over time

15. NAMAF PROJECTS NAMAF has embarked upon the following projects:
Namibianisation of the Tariff Publication
Alternative Dispensing fee Model
NAMAF Centralized Data Repository
NAMAF Practice Coding Numbering System (PCNS)

16. Namibianisation of the NAMAF Benchmark Tariffs
Over the last five years NAMAF has developed unique processes whereby:
Tariff codes and descriptors are updated in collaboration with the various professional bodies
Year on year increases in the benchmark tariffs are calculated by using formulas that take into account objective facts with respect to increases in the underlying costs
Cost of equipment is calculated by using formulas that take into account aspects such as purchasing prices, cost of financing and maintenance costs
In short, NAMAF has over the last five years implemented  transparent process through which the year on year increases in the NAMAF benchmark tariffs are determined objectively.  This is a unique process and comes as a result of ground breaking work that has been done.

17. NAMAF Alternative Dispensing Fee Model
NAMAF has identified a need to develop an alternative dispensing fee model that will incentivise pharmacists to:
Provide patients with cost-effective medicines; and
Increase the utilisation of generic medication
Central to the process is that:
 The result should be cost neutral to the pharmacists as well as the funds and
The process should be participative and based upon consensus
Although a new model has not yet been implemented, good progress has been made toward finding common ground and announcements will follow in the near future.

18. NAMAF Centralised Data Repository
NAMAF has commissioned the development of a centralised data repository that will allow for, for example:
Performing of comparisons against benchmarks;
Understanding industry trends;
Analysis of industry issues.
The first phase of development has been completed and individual funds have been given access in order for them to test their own data and provide feedback

19. NAMAF Practice Code Numbering System
It is NAMAF’s intention to develop its own practice code numbering system and to reduce its dependence upon the South African system.  This project will formally kick-off during the second half of 2014.
However, a provider database and lookup tool has already been incorporated in the centralised data repository and this will form the basis of the NAMAF practice code numbering system.

20. NAMAF FORUMS
NAMAF has implemented forums to foster good relationships and to tackle relevant matters at an appropriate forum. The forums are as follows:
Peer Review Forum
Hospital Forum
Administrators Forum

21. FIM BILL The FIM Bill is currently with the legal drafters
Subsequently it will be referred to the Cabinet Committee on Legislation (CCL)
There is no definite date for implementation of the FIM Bill

22. STANDARDS & REGULATIONS
NAMFISA promised to consult the industry on the standards & regulations.
NAMFISA will discuss the standards & regulations first internally and than with the industry.
Industry consultations will be done via workshops.

23. COMPETITION COMMISSION ISSUES
The investigation of the industry by the Namibian Competition Commission (NCC) is still pending.
A number of submissions have been forwarded to NCC by our legal representative i.e.. Mr Hartmut Ruppel of LorentzAngula Inc.
NAMAF and the Funds were served with Form 6 Notices.
According to NCC, NAMAF & the Funds contravened the provisions of Part 1 of the Competition Act and mores specifically section 23(1) read with section 23(2).
The Commission considers approaching the Court under section 38 0f the Competition Act.
NAMAF is of the opinion that we are not an “undertaking” as per the Competition Act.
NAMAF believes that the Competition Act has no bearing on NAMAF as a statutory body.

24. Thank you