Documents published by the Health Market Inquiry for comment:
- Claims data analysis
- Market Definition for Financing of Healthcare
- Summary of Results Healthcare Consumer Survey 18 November 2016
The BHF tendered a comprehensive submission to the Competition Commission Inquiry, detailing the many areas which stifle access and efficiency within the system.
BHF calls for a comprehensive and informed review of legislation governing the private health sector in order to address these and other issues.
The submission emphasizes that the healthcare market is not a ‘normal market’ because of the asymmetry of information, provider-induced demand and aspects relating to price. Therefore, competition in the healthcare market works to the detriment of the consumer. BHF believes that regulation of prices and other regulatory control is needed to protect patients and to ensure affordability of healthcare services.
The submission highlights areas where current regulation of the market is ineffective and in some cases even detrimental to consumers. It also calls for measures to be introduced to counter the effects of consolidation of private hospitals on prices and measures to limit the prices that medical specialists can charge for their services. Other concerns within the realm of specialists include the practice of unbundling of codes so as to extract greater revenue from medical schemes and their members.
The untransparent price setting in the private hospital environment is of significant concern to BHF and the submission calls for this to be addressed.
The private health sector is completely out of alignment with government health policy in that the former emphasizes secondary and tertiary levels of health care
at the expense of primary and preventive health care. Poor outpatient quality of care and its consequent adverse outcomes exacerbates the hospicentric nature of private health care.
The BHF submission calls for amendments to the Medical Schemes Act so as to better control the powers of the Council for Medical Schemes and the Registrar and to prevent their attempts to regulate by circular.
The insurance industry is creating products that compete with medical schemes on different and unfair playing fields. The BHF believes that these products mislead the general public and create incentives for irresponsible consumer behaviour when making health care funding decisions. These Hospital Cash Plans (HCPs), as they are commonly known are causing medical schemes to incur expenditure for hospital admissions that would never ordinarily have occurred. Industry reports indicate that members with ‘Hospital Cash Plans’ are admitted to hospital five times more and stay 40% – 60% longer than those who do not have these insurance products.
The BHF submission concludes by calling for regulatory intervention by the Minister of Health, especially in the form of regulation of prices in the private health sec-tor to protect patients from exploitative pricing of some heath service providers and product suppliers.
BHF believes that the National Health Act and Section 27 of the SA Constitution provides the Minister of Health with the necessary powers to make a positive impact on the sector and the lives of all South Africans.
Terms and reference for the healthcare inquiry
Publication of Statement of Issues and Guidelines for Participation in the Market Inquiry into the Private Healthcare Sector
14 September 2014 (BHF Submission)
Please click on the links to view the full submission and relevant annexures. Submission on the Inquiry into the Private Healthcare Sector; Annexure A; Annexure B; Annexure C; Annexure D; Annexure E; Annexure F; Annexure G and Private Healthcare Cost Drivers PPT
5 February 2015 Information Session
- On the 5th of February 2015, the Panel of the Market Inquiry into the Private Healthcare Sector (“health inquiry”) held an information session on the status of the inquiry.
Please click here to view the speech by the Chairperson of the Market Inquiry Retired Chief Justice Sandile Ngcobo.
- Please click here to view the various submissions.