Posts tagged with 'Competition Commission’s Health Market Inquiry'

 

The Private healthcare industry needs to change

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The “startling costs” of South African private healthcare is at the heart of the Competition Commission’s Health Market Inquiry (HMI) draft report released in July. While cost is a key theme, the report also describes a sector lacking the vital force of authentic, robust competition.

Currently, the South African private healthcare sector is an opaque system dominated by a small handful of players. Members pay for medical scheme cover, and accept that they will also have to pay costs out of their own pockets.

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The common refrain of the medical aid will pay is one that is inherently false. It is not the medical aid that pays, but the member. “The fact that so many people cling to this erro
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‘Private healthcare not affordable, even for people who are supposedly rich’

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The findings of the Competition Commission’s Health Market Inquiry released today reveal what Health Minister Aaron Motsoaledi says he already knew – that private healthcare has become so exorbitantly expensive, even those on medical aid can’t afford it.

Moreover, the commission found – during its more than four-year-long investigation – that the market was characterised by high and rising costs of healthcare and medical scheme cover, disempowered and uninformed consumers, and a general absence of value-based purchasing.

“That private healthcare has become costlier and costlier has been proven today, some of us knew it long ago back in 2009 that private healthcare no longer affordable, even for people who are supposedly rich who are on medical aid can’t afford it,” Motsoaledi said at the briefing held in Sandton to announce the release of the much anticipated provisional report.

According to the inquiry’s chairperson, former Chief Justice, Sa
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Medical Schemes amendments could threaten schemes’ sustainability

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While the proposed amendments to the Medical Schemes Act seek to lower the cost of private healthcare, they may have the unintended consequence of threatening the sustainability of medical schemes.

The amendments look at abolishing the practice of copayments on certain benefits, removing waiting periods and prescribed minimum benefits and tapping into the reserves medical schemes are required to hold.

These provisions in isolation could affect the financial stability of medical aids, says Lerato Mosiah, CEO: Health Funders Association (HFA). “Whilst we welcome the dialogue in the sector, it is critical that this takes into consideration the broader picture and context. It is thus important to understand that medical schemes utilise risk management measures in order to ensure that they remain viable.

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New Act could redress medical scheme sustainability issues

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Health Minister Aaron Motsoaledi has hinted at a number of reforms that directly address challenges of sustainability that the medical schemes industry is currently facing.

“We know that rising costs in healthcare are outstripping inflation, and legislated steps to address this are overdue. The proposals will usher in a new set of rules for how medical schemes operate,” says Mark Arnold, principal officer of Resolution Health Medical Scheme.

“While the details of how uniform tariffs for healthcare providers will be arrived at are not expected to be addressed in the Medical Schemes Amendment Bill, but rather will be informed by the outcome of the Competition Commission’s Health Market Inquiry, this is an important step towards protecting healthcare consumers.”

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