On the National Health Bill
The Board of Healthcare Funders of Southern Africa supports the principle of collective bargaining between medical schemes and providers of health care services as it will, if executed appropriately, bring about transparency in pricing and ensure that fair and reasonable prices are paid for relevant health services.
In its submission made to the Director General of Health on the Bill, BHF identifies several areas where clarity is sought. Of particular concern is that there is no clarity on whether the amendments are intended to apply in respect of the private or public health sectors. It is also not clear whether they are intended to apply only in respect of medical scheme beneficiaries and medical scheme funded-health care or across the entire spectrum of private health care.
BHF also raises a concern around the possible impact of delays in terms of referrals to the tribunal who have three years to resolve matters. These concerns centre around the fact that schemes would still have to pay benefits to members in the meantime, as retrospective reimbursement of claims is administratively expensive. Medical schemes also budget annually and would not know how to make allowances for matters before the tribunal two or three years in advance.
Schemes may be impacted if the tribunal can order the payment of money, delivery of services or cancelling of contracts. This may affect benefit design and budgeting by schemes. Medical schemes have a relatively fixed income and cannot suddenly cater for significant changes in their liability on the basis of decisions by the Tribunal.
The BHF submission also raises questions on the way in which the amendments will deal with the implications of the concurrent jurisdiction exercised by the Competitions Act, which does not allow collective bargaining at any level. The Amendment Bill will have to be very specific to override these provisions of the Competition Act.
For further information, please contact Heidi Kruger, Head of Corporate Communications on 011 5370237, 0829051161 or Heidik@bhfglobal.com
