Sin tax viable option to significantly improve hea...

Sin tax viable option to significantly improve health service delivery for Zim’s medically uninsured 95 percent

Audrey Galawu

Economist and Policy Expert Prosper Chitambara says sin tax on things like sugar and alcohol could increase access to quality health care for the majority of Zimbabweans who cannot afford prescription medication, specialist fees, hospitalisation as they have no medical insurance.

“Currently about 5% of Zimbabweans are on some form of medical aid cover and I believe that we must come up with some national healthcare insurance scheme that is funded through sugar taxes or even taxes on cigarettes and alcohol,” said policy advisor at the Labour and Economic Development Research Institute of Zimbabwe while addressing a post-budget review meeting in Harare this Monday.

Chitambara, a senior research economist, said sin taxes was proposing ways to build up the public health sector which has seen some improvement in the past two years but is still way below standard.

“We can further enhance the health and wellbeing and social aspects of our citizens. It was recently proposed that 10% of tax should be channelled towards the creation of a national health scheme to afford uninsured vulnerable groups health cover,” Chitambara said.

Formally employed Zimbabweans contribute to the National Aids Levy and they make up a significant number of the five percent citizens with health insurance.

The Public Service Commission which is the biggest employer in the country is linked the Premier Service Medical Aid Society for health service delivery to public sector health workers.

Between 80 and 90 percent of Zimbabweans are either self-employed or working for non-formal SMEs that do not have health benefit packages.

For Zimbabweans who can afford top notch private care, health delivery access is a whole different world from the challenges that face the masses. These include industrial action in the form of strikes or go-slows, as well as shortages of medications.

Community Working Group on Health executive director Itai Rusike said there is need to introduce a mandatory national health insurance scheme to ensure universal health coverage for all.

“In line with regional and global best practices, the national health insurance can be publicly funded through a combination of sin taxes from cigarettes and alcohol as well as sugar taxes to ensure primary healthcare to every Zimbabwean.

“The sugar tax, apart from reducing consumption of sugary drinks, also raises additional revenue for Treasury,” Rusike said.

In October 2021 Vice President and Health Minister Constantino Chiwenga proposed the same concept saying it should be incorporated in the national budget:

“The ministry is proposing that a certain percentage of the Zinara funds be ring-fenced to finance health services such as purchasing ambulances required in cases of road traffic accidents and the treatment of victims of accidents requiring hospitalisation,” Chiwenga said.

“It is also proposed that a certain number of cigarettes be reserved for financing health, for example, for every five packets sold one goes to the national health services. With regards to alcohol, a certain number of bottles should contribute to financing healthcare services. So let us have a cent from alcohol, cigarettes and Zinara fees, to fund national health services,” VP Chiwenga said.

In May 2019, then Health Minister Dr Obadiah Moyo announced that a national health insurance scheme had been structured and would soon be operational.

More than three years later, now in December 2022, it has not yet materialised.