On Friday 21 September 2007, a delegation from the BHF attended the private health sector indaba called by the Minister of Health. All of the major stakeholders were represented at this gathering of some 200 people. Each sector was given 15 minutes to present its views. The MEC for Health in Gauteng led the meeting.
In her opening speech Minister said that the fee for service model has been recognised internationally as unsustainable, unaffordable and not ethically justifiable. She said she did not believe that patients were adequately protected against exploitation by health care providers. The Minister also stated that there is inadequate diversity in the areas of ownership and competition and that as a result there was no downward pressure on costs. She was of the view that the private health sector needs a coherent regulatory framework to ensure that it operates in the best interest of all the citizens of the country and not just its shareholders.
A summary of the key recommendations, presented by the MEC for Health, Mr Brian Hlongwa
Dr Humphrey Zokufa presented on behalf of the BHF in accordance with a document that was prepared by the BHF Board appointed Indaba Task Team and submitted to the Minister by the funding industry. Some of the important points made in this document are:
- that if there is to be any self-regulation within the provider sector it would have to be within a legislated framework that creates the necessary incentives and discourages undesirable behaviour. Such a framework would have to include checks and balances to ensure that it achieves its objectives;
- the balance of power between funders and providers needs to be equalized. Medical schemes are heavily regulated but providers are not;
- there needs to be detailed transparency on revenue streams and estimation of tariffs so as to protect the medical scheme member from unreasonable cost-shifting;
- broker reimbursement needs to be transparent and performance based and brokers must provide adequate value for money;
- it is not sustainable for schemes to have PMB obligations and at the same time face no limits on what providers can charge for PMBs;
- allocative efficiency needs to be dealt with by restoring the general practitioner as the gatekeeper and by regulated benefits that create the right mix of incentives to ensure the primacy of primary health care in the system.
| Attachment | Size |
|---|---|
| Minister of Health Indaba speeches as per DoH website 2007.pdf | 18.85 KB |
| summary.pdf | 21.82 KB |
