Weekend Read| Who Pays When Zimbabwe’s Emergency Bells Ring?

By Tinotenda Bhunu

HARARE – THERE is a saying that every economist eventually learns: there is no such thing as a free lunch. Every benefit enjoyed by one person is paid for by someone else, even if that payment is not immediately visible.

In recent days, I have seen many people celebrating the new provision in Zimbabwe’s Medical Services Amendment Act requiring private hospitals to admit and stabilise emergency patients for up to 48 hours, regardless of their ability to pay.

The praise is understandable. After all, who would want someone turned away while fighting for their life simply because they cannot immediately produce a bank card or cash deposit?

Yet, as an economist—and particularly one influenced by Austrian Economics—I find myself asking a different question: Who ultimately pays?

I have heard many people praising socialism. In my belief, they are entitled to that view because many genuinely do not realise that nothing is ever truly free. There is always an invisible hand paying for it. The question is not whether a service has a cost; the question is merely who bears it.

That distinction matters.

Imagine a father rushing his child to the nearest private hospital after a serious road accident. The doctors know every second counts. Under the new law, the hospital cannot refuse treatment simply because the family cannot immediately pay. It must admit the patient, provide emergency care, and stabilise them before any transfer.

Morally, this feels right. Economically, however, the story has only begun.

The medicine used to save that child was purchased by someone. The oxygen was paid for. The ambulance, intensive care equipment, specialist doctors, nurses, and electricity all carry costs. None of these become free because Parliament passes a law.

The amendment does not eliminate those costs. It simply changes who carries them.

This is where Austrian Economics offers an important lesson. Economists such as Ludwig von Mises and Friedrich Hayek consistently argued that every government intervention changes incentives. Policies should, therefore, be judged not only by their intentions but also by their unseen consequences.

The visible consequence of this law is obvious: more Zimbabweans facing life-threatening emergencies will receive treatment without first proving they can afford it.

The unseen consequences deserve equal attention.

If the government promptly reimburses private hospitals through transparent cost-recovery arrangements, then society effectively shares the burden of emergency healthcare. The private sector remains financially sustainable while citizens gain greater protection.

But if reimbursement is delayed, incomplete, or absent, private hospitals become involuntary financiers of public healthcare. They continue purchasing medicines, paying specialists, and maintaining equipment while carrying growing unpaid bills.

Eventually, those costs do not disappear. They may reappear as higher medical fees for paying patients, reduced investment in new facilities, fewer specialists entering private practice, or hospitals becoming more cautious about expanding services.

Economics teaches us that costs cannot be legislated away. They can only be transferred.

This is precisely why emergency healthcare represents a unique case. Unlike ordinary markets, a patient suffering a stroke cannot compare prices or negotiate contracts. Austrian economists recognised that markets function best where voluntary exchange is possible. During a medical emergency, voluntary choice is severely constrained, creating circumstances where some government intervention may be justified.

The challenge is ensuring that intervention respects economic reality.

Good intentions alone cannot finance hospitals.

The State’s promise to reimburse private institutions is, therefore, not a technical detail—it is the foundation upon which the entire reform rests. If those promises are honoured, the law could save countless lives without undermining the private healthcare sector.

If they are not, the policy risks weakening the very institutions it depends on.

In economics, there is an important distinction between what is seen and what is unseen.

We will all see the patient whose life is saved because a hospital was legally required to treat them.

What we may not immediately see are the financial pressures placed on hospitals months later if compensation never arrives.

Both realities matter.

Ultimately, this law reminds us that compassionate societies and economically sustainable policies are not mutually exclusive. We can believe that no Zimbabwean should be denied emergency treatment because they are poor while also recognising that someone must finance that compassion.

There is no contradiction in holding both views.

The real success of this reform will not be measured by the words written in the Act. It will be measured by whether Zimbabwe can build a healthcare financing system where saving lives today does not undermine the capacity to save lives tomorrow.

Tinotenda Bhunu is an economist by profession. LinkedIn: https://www.linkedin.com/in/tinotenda-bhunu-114645208?utm_source=share&utm_campaign=share_via&utm_content=profile&utm_medium=android_app