Press Release by the Board of Healthcare Funders (BHF) on the Green Paper on NHI

BHF and its members have been supportive of universal access to healthcare and welcomes the Green Paper on NHI, which has provided certainty and clarity in many of the areas which have been debated over the past few years.

When we consider the problems in the public sector, such as the lack of resources and the burden of disease, and those in the private sector, such as pricing, affordability, coding and legislative issues, there is no doubt that the entire healthcare system is in need of an overhaul.

We are especially encouraged by the fact that the Paper recognises the expertise and infrastructure which exists in the private sector and which could be utilised under the NHI.

BHF welcomes the document’s support of an emphasis on primary and preventative care within the benefit package. To this end, we would encourage a review of the current Prescribed Minimum Benefits to reflect this focus in line with National Health Policy.

With regards to payment of providers under NHI, we believe that the proposed risk-adjusted capitation system is one which will constructively promote good quality outcomes and will minimise the potential for fraud and over servicing which is often accompanied by a fee-for-service model.

BHF has promoted the use of DRGs (diagnosis related groups) for a number of years and we believe that the proposed intention to use DRGs to reimburse hospitals under the NHI is correct. The use of DRGs also enables the analysis of risk and may be used as a tool to measure quality.

We support the strengthening of the public health system and transformation of the health services delivery platform as we believe that, in the build-up to NHI, medical schemes could explore these as alternatives to the current private hospitals.

As a precursor to NHI, we would like to urge the Minister of Health to establish the proposed “Healthcare Pricing Forum” so that, for the sake of the consumer, medical schemes remain sustainable in the lead up to the implementation of NHI.

The BHF NHI Task Team, which is made up of actuaries, clinicians and experts from the administration, medical scheme and managed care environments, will begin formulating the industry submission to the Green Paper.

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For more information, please contact Heidi Kruger, BHF Head of Corporate Communications on 0829051161, 011 5370237 or e-mail heidik@bhfglobal.com

The BHF is the representative organisation for the majority of medical schemes throughout South Africa, Namibia, Zimbabwe, Botswana as well as Lesotho. As the industry representative body, the organisation relies on the membership of all medical schemes to ensure that it is able to lobby government and other organisations effectively and to influence policy where necessary on behalf of the entire industry.