THE country has the knowledge, skills and capacity across all sectors, public and private, to make universal quality healthcare a reality, says Blum Khan, CEO of the Metropolitan Health Group.
He warns, however, of the need to design the NHI (National Health Insurance) model correctly. "We must also concentrate on collaboration and partnership, rather than elimination and division, if we want to make a real difference to the life of all South Africans."
He says the private medical scheme industry has anticipated and supported a NHI over the past few years and adds, "I believe there is room in South Africa both for a national health insurance scheme and for private medical schemes."
Khan elaborates on his idea for a NHI model that would deliver far improved healthcare for the nation and save the state hundreds of millions of rands. This, in turn, could be used to improve delivery in vital areas such as in the treatment of HIV and TB.
"In addition to these improvements, people who have become accustomed to acquiring optional benefits beyond the basic minimum level of service will be allowed to continue doing so. This includes a private hospital room or access to cosmetic medical procedures.
"In my model, the strengths of the public and private healthcare sectors will be combined and the weaknesses substantially reduced. I strongly subscribe to the notion that we should strive to transform our society and infrastructure and make it more relevant for the South Africa we now service.
"For me there seems little value in destroying what we have and more so in a world where scarcity of skill and limited resources remains a reality"
Among several suggestion he makes is the need for public and private sector partnerships and for all working South Africans and foreigners to contribute between 1,75 percent and 2,5 percent of their taxable income to NHI.
"These contributions would fund a network of NHI hospitals to which any contributing South African could go and would be assured of a reasonable level of healthcare. The unemployed could be catered for through a network of specific hospitals in each area that ensure access, quality of care and dignity for all. A hospital like Groote Schuur in Cape Town might be categorised in this way.
"With private hospitals also in play there would be fewer bottlenecks as people are channeled to hospitals appropriate to their situation and needs."
While conceding that those who opt for private care will also have to contribute to the NHI and will probably lose their tax subsidies, he says their preferences will still be catered for.
He suggests that NHI hospitals should be run and administered by private contractors and that this should be put to tender.
"To ensure that the state inherits an efficient, smooth-running operation, back-office administration should be tendered out for 15 to 20 years to crack down on corruption and false claims. Taking a large number of hospitals off the state's books for 20 years should immediately result in the saving of tens of millions of rands."
Khan also believes that only way to attract medical skills from overseas and retain our own would be to change the way professional bodies allow people to qualify. "Incentives would bring people on short-term contracts and doctors in rural areas should be paid more and enjoy greater benefits and perks than their urban counterparts."
Private sector general practitioners would serve as providers, conforming to the clinical protocols and guidelines set by NHI, which will see an estimated seven million new patients nationally.
"We also need to review tilt manner in which licenses are held and re-issue or issue additional licenses to enable more competition to prevail in the industry."
In conclusion, he says it is in evitable that the private system, will undergo fairly serious restructuring and change. However, the inclusion of private sector skills, facilities and administrators in a new NHI network will offer a range of nevi opportunities and possibilities.
"Medical schemes and their management will have to be flexible and efficient," he warns.
Loraine Tulleken: Business Report, 28 May 2010
