THE national health minister has mooted setting up a pricing commission, possibly along the lines of the National Energy Regulator of SA (Nersa), for all relevant healthcare tariffs to be discussed.

Heidi Kruger, head of corporate communications for the Board of Healthcare Funders of Southern Africa (BHF), the industry body for medical schemes and administrators, says: "Hopefully this will bring some certainty to the market with regard to tariffs. We regard this as a constructive development."

She says that the lack of transparency in what constitutes the drawing up of private hospital tariff structures is an ongoing concern. This, added to the fact that there has not been much movement on this issue over the past few years - apart from the proposed pricing commission - presents a challenge for medical schemes, Kruger says.

Another contentious issue is the absence of a regulatory framework for the governance of healthcare institutions, which is not confined to private hospitals and clinics alone but covers a range of institutional healthcare facilities.

"As we move towards a national health insurance (NHI) scheme, these issues should be resolved over time, but the establishment of the NHI could take some time to bed down."

She says that one of the main concerns for medical schemes remains the prescribed minimum benefits package - the basket of basic benefits that medical schemes are obliged to cover in full. There is evidence to show that for those particular procedures the tariff costs are much higher than for others, which in itself is problematic for medical schemes, says Kruger.

David Jackson: Business Day, 7 May 2010