Private doctors in financially troubled Zimbabwe have increased their fees by more than 500 percent, and they are demanding payment in cash even for patients on medical insurance plans. The move likely will make it even more difficult for ordinary Zimbabweans to get healthcare.

It will now cost a patient on medical insurance more than $50 for a visit to the doctor, up from $10 at the official rate.

The physicians announced the increase after the collapse of negotiations with medical insurance companies. The president of the Zimbabwe Medical Association, Dr. Billy Rigava, said private doctors decided on the hefty hike as a result of the current hyper-inflationary climate the country is experiencing.

Dr. Rigava also said they had decided on demanding cash up front from patients because medical insurance companies were taking too long to pay them after they had attended to patients. He said some medical insurance companies were taking up to more than two years to pay the doctors after submission of their claims.

Dr. Rigava accused the insurance companies of engaging in non-core activities such as investing their members' money, resulting in large sums of money being tied up and none left to pay the doctors.

The medical association chief said the talks collapsed after the insurance companies offered payment in 30 days. As Dr. Rigava put it, We are demanding payment within a week after submitting claims, and no more. He said that because of Zimbabwe's current economic situation, the doctors were finding it increasingly difficult to meet their own costs.

Medical insurance is not compulsory in Zimbabwe and membership is open to most people with a regular job as well as their families.

Private doctors have for some time now provided an important alternative to the country's public health system, which has all but collapsed due to the shortage of foreign currency to buy essential drugs and equipment.

Doctors in the public sector have been on strike since last October for more money. Nurses also have joined the strike.

A skeleton staff of army doctors and nurses and student nurses is now manning Zimbabwe's hospitals. No end to the strike is in sight, and some doctors and nurses are resigning and joining the exodus of skilled Zimbabweans to countries where they can get better pay.