The Board of Healthcare Funders response to Dr Motsoaledi’s comments at the COSATU Central Committee meeting
The BHF welcomes Minister Motsoaledi’s comments made at the recent COSATU Central Committee meeting, and agrees that charges within the private healthcare sector need to be addressed as a matter of urgency. According to the Council for Medical Schemes Annual Report for 2009-2010, Private Hospitals benefited 37% of what was paid out by medical schemes and Medical Specialists benefited 21.9%. Therefore 58.9% of what was paid out benefited these two providers. The big concern is the R2.5billion deficit that the medical schemes experienced.
The Minister’s comments around the profiteering by private hospitals vindicate the stance which BHF has taken on the regulations relating to the payment of Prescribed Minimum Benefits. In a court case scheduled for later this year, the BHF will argue on behalf of medical schemes and their members that schemes should not be required to pay for these conditions at whatever fee the healthcare provider charges. This can be regarded as reckless spending at a time when prudent spending is advocated.
Medical schemes experience opportunistic charging by healthcare service providers on a daily basis. This is extremely detrimental to the private healthcare industry as the related costs are increasingly prohibiting consumers from being able to afford private healthcare.
Since 2004, all cost containment measures, such as collective bargaining, the NHRPL and the HPCSA ethical tariff list have been removed from the system. This means that there is now no limit on the fees which healthcare providers may charge for their services, thereby creating an open-ended liability for patients and medical schemes. This is clearly not in the interest of the consumer.
BHF therefore greatly appreciates the Minister’s concerns on these issues and fully supports the Minister’s intention to establish a pricing negotiating chamber to arrive at tariffs which are fair and reasonable both to the provider and the medical scheme member. BHF believes that this intervention will help to contain costs and will assist in moving the focus from one of financial gain to good healthcare outcomes and efficient delivery. May the Minister of Health get full support from all Government institutions and Departments in this initiative for the benefit of the ordinary consumer.
“Medical scheme members must realise that medical schemes are ‘stokvels’ of their money, taken care of by the Boards of Trustees of medical schemes. The members/consumers all contribute equally to the fund and payments are made according to need. So if private hospitals are charging more than they should, everyone on the scheme suffers as premiums increase”, says Dr Zokufa, MD of BHF
The BHF fully supports the notion of universal access to healthcare, and believes that NHI, if properly implemented, could solve many of the challenges being faced by the country’s health system. To this end, we have established a task team to formulate a position on the proposed NHI system, so that guided by the Minister of Health, we can play a supportive and meaningful role.