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The announcement by the City of Harare that it will launch a low-cost medical aid scheme for residents is wonderful but the major question is whether this programme will deliver on its promises.The director of health services for Harare, Dr Prosper Chonzi, on Tuesday said that city authorities are in the process of applying for a licence from the Ministry of Health and Child Care to implement the scheme, which will see residents contribute as little as US$3 per month to ensure access to medical services provided by the municipality.

The scheme will target low-income earners, particularly in the informal sector, most of whom are currently forced to find cash for medical services — including in emergencies —thus compromising access as costs are high and cash is short.

Other cities are considering similar programmes.

Most medical aid programmes currently cost more than US$50 a month for a family of four. Thus they favour the formally employed who are cushioned through concurrent subscriptions by their employers.

Many Zimbabwean urbanites turned to self-employment on the back of massive retrenchments under the IMF-initiated Economic Structural Adjustment Programme in 1992.

Other factors later worsened the situation and it is noble for the city leaders to come up with ideas on how to include the populace that has been sidelined.

While no one can argue with the vision, questions arise on whether the reality will match the dream or if we will see this turn into yet another money generating programme that appears to only benefit those at the helm of the city’s affairs.

Will these people have the willpower to use the money generated by members’ contributions for the stated purposes or will it be diverted to other uses which bear no value to the intended beneficiaries?

We feel that we are justified in raising this pertinent question on behalf of the residents of this city.

When it comes to service delivery the city leaders are quick to whine about lack of funds. But the same impediment seems to miraculously dissolve when money is needed to fund fabulous packages for people, — some of whose sole value to the city would appear to be only the ornamental decorations of their vaunted certificates on their office walls.

The current crop of city mothers and fathers has demonstrated a deplorably deep regard for their own comfort and luxury at the expense of the ratepayer.

Dry taps, uncollected garbage, vandalised amenities and ruined roads have become the hallmark of our once beautiful city as the chief administrators concentrate on buying luxury vehicles, going off on exotic holidays and sending their offspring to prestigious schools. To succeed, the medical aid scheme needs massive buy-in from the residents and this can only come if the targeted people are confident that the programme will benefit them.

It is unlikely that too many people will feel confidence in entrusting their money and health to the current city leadership, especially in light of the scandals that have been exposed at Town House and at major medical aid organisations.

Perhaps it would be wiser to have the medical insurance scheme established as an independent body with the contributors having a fair say in the administration of their funds.