Posts tagged with 'National Health Insurance'

 

How your medical bills may change under the National Health Insurance

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Many private hospitals will be opening their doors to more patients but does that mean you’ll be stuck at the back of the queue?

The United Kingdom’s universal healthcare system, known as the National Health Service (NHS), had a problem: By the early 2000s, a growing number of elderly patients were waiting up to three years for sight-saving cataract services in the early 2000s.

But the government-funded healthcare scheme didn’t have enough beds. It did, however, have plenty of parking.

“All we needed was a parking lot and a connection to three-phase electricity,” remembers South Africa’s Netcare CEO Richard Friedland.

Netcare entered the UK market fifteen years ago. It operates more than 50 private hospitals in the country, but 43% of its patients come from the NHS through the service’s electronic “choose and book” appointment system: Patients elect where to go for care, and the NHS pays private providers like Netcare a nationally-set rate
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#HASA2017: NHI needs to start delivering now

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South Africa can’t wait for the final National Health Insurance (NHI) system in 2026 to start delivering on universal health coverage, but needs to start implementing projects and programmes that will make a real difference in people’s lives now. And this can’t be done without cooperation between the public and private health sectors.

This was the overarching message in a high-level panel discussion of chief executives from the private healthcare sector at the Hospital Association of South Africa (Hasa) conference currently underway at the Cape Town International Centre.

White paper is not enough

“NHI, in principle is the right thing to do, but implementation is the key,” said Vishal Brijlal, National Department of Health (DoH) advisor on NHI. “We have a white paper, but that is not enough. The policy needs to be followed by planning, implementation, and cooperation.

“We can’t just wake up on 1 April 2026 and hope by some miracle that NHI will be
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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.

Looking for a affordable Medical Aid or Hospital Plan, just click here Medical Aid or just send your Name, surname, age and email address to 082 738 5586

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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Is SA’s healthcare getting better?

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Globally, noncommunicable diseases were responsible for 70% of deaths in 2015, up from 60% in 2000. Ischaemic heart disease was the leading cause of death accounting for 8.8 million deaths in 2015, followed by stroke (6.2 million deaths) and lower respiratory infections (3.2 million deaths).

Communicable (infectious) diseases, on the other hand, were the cause of 12 million deaths worldwide in 2015 (in total), especially in low-income countries. These diseases include lower respiratory tract infections, diarrheal diseases, HIV/AIDS, tuberculosis and malaria.

In South Africa, the number of deaths recorded in 2015 totalled 460,236 (compared to over one million births), indicating a 3% decline in deaths processed between 2015 and 2014. The majority of deaths were due to noncommunicable diseases (55.5% in 2015), an increase from 42.9% in 2005.

Interestingly, when compared to the global situation, the leading cause of natural deaths in South Africa in 2015 was t
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The maddening state of Gauteng’s psychiatric facilities

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A massive shortages of hospital beds for psychiatric patients in Gauteng is compromising patient care.

Gauteng is short of about 2700 psychiatric beds which means that psychiatric patients have to be admitted to general wards where there is no security, thus posing a threat both to themselves and others.

This was revealed recently by Gauteng Health MEC Gwen Ramokgopa in a 22-page statement handed to the Gauteng Legislature in response to questions about the state of psychiatric care for hospitalised patients.

By the time a person with a psychiatric illness is hospitalised, their symptoms are usually severe and patients may be suicidal or psychotic.

The World Health Organisation (using prevalence US figures) estimates that up to three percent of a population will have severe psychiatric conditions and need hospitalisation. This excludes figures for people with substance abuse-related disorders and post-traumatic stress – so it is likely to be an under-esti
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Nearly 2 million will lose private healthcare if tax reform happens

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The government’s plan to ditch medical aid tax credits will have a disastrous effect on already cash-strapped South Africans and force nearly 2 million people onto the over-stretched state health system.

If the tax credit is removed, 22% of medical aid users will not be able to afford cover, Stellenbosch economics consultancy Econex warned in a report published on Friday – 1.9 million of the 8 million medical aid members, including children, will have to drop out of the private healthcare system.

In a national health insurance policy document released in July, Health Minister Aaron Motsoaledi said he wanted to remove the tax credit to users, which amounts to R20-billion a year.

Medical aid schemes’ members get a tax reduction of R3,636 a year – or R303 a month. Motsoaledi said then that “the tax credit … we believe, is unfair”.

Economist Paula Armstrong, author of the Econex analysis, said the rebate was intended to “alleviate some pressure on the state [
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Hot Medical News:- Hi-tech lung cancer lab to benefit all

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If the country is to reduce its high cancer statistics, the public would have to be educated about the illness and preventative measures taken, says Gauteng Health MEC, Dr Gwen Ramokgopa.

Ramokgopa was speaking at the launch of the state-of-the-art Lung Laboratory at the Helen Joseph Hospital, in Johannesburg.
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Do you really think you’re going to opt out of the NHI when it comes?

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1. Will you be able to say “thanks, but no thanks”?
If the National Health Insurance (NHI) Bill is passed in its current form, the NHI will be compulsory, regardless of whether you also belong to a private medical aid. So, opting out won’t be possible. The Bill says the NHI, which will be like a big, state-funded medical scheme, will be a free service, but it doesn’t tell us what benefits will be covered, how the scheme will be paid for or how much it will cost.

2. When will the NHI start, and, will it actually happen?
The NHI Bill says the scheme will be implemented in three phases — we’re currently in the second phase (2017 – 2022), during which NHI legislation has to be developed and the NHI fund has to be established. During the last phase, from 2022 – 2026, Cabinet has to approve “the mobilisation of additional resources” so that the NHI can start to buy healthcare services from both public and private providers
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NHI white paper issues raised – National Health Insurance

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The two fundamental issues with the new white paper on National Health Insurance (NHI) are a single payer fund and the nationalisation of private healthcare without compensation.

Single payer fund

In terms of the single payer fund, the white paper believes that the NHI can use bulk purchasing power to drive down the price of healthcare services. However, it then simultaneously declares that it will accredit medical service providers – public and private – and then set the prices at which they can sell their services to the NHI. It specifically states that it will deploy a “uniform reimbursement strategy” and that accredited service providers will not be allowed to deviate from that.

This raises a fundamental question. If the NHI is going to regulate the price at which the services are being procured, why does it need to use the bulk purchasing power of a single fund to reduce prices?

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How will private healthcare evolve under Universal Health Coverage (UHC)?

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With National Health Insurance, the Competition Commission investigation and sky-rocketing costs, it’s no wonder that the private healthcare sector (and the public sector for that matter) is a tad wary about what the future holds.

However, in which ever way, shape or form it manifests itself, universal health coverage (UHC) is inevitable. It forms part of the United Nations’ sustainable development goals. “To promote physical and mental health and well-being and to extend life expectancy for all, we must achieve universal health coverage and access to quality healthcare. No one must be left behind. This places UHC as the target that underpins and is key to achievement of other Goal 3 targets.”

Set of goals

According to Dr Rufaro Chatora, World Health Organisation (WHO) country representative says UHC provides a set of goals rather than tell us how to organise a health system. “This is logical as each country faces different challenges
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Syndicates and devious health professionals may target National Health Insurance

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Criminal networks are targeting your medical aid rands but could you be part of the problem too?

Criminal syndicates and unscrupulous doctors may be defrauding the private health sector of millions as experts warn that medical schemes may reach a breaking point.

“The health care sector is being targeted by criminal syndicates and even devious practitioners. It is a direct threat to the financial viability of medical schemes in the country, including any National Health Insurance initiative we attempt,” says medical advisor on healthcare forensics at medical aid administrator and risk management service, Medscheme Gregory Pratt. Pratt was speaking at the Board of Healthcare Funders Southern African Conference this week in Cape Town.

“The affordability of medical schemes in the country will soon reach a tipping point.”

In 2013 alone, Discovery Health recovered R300 million in fraudulent claims alone – a number that in 2014 CEO Jonathan Broomberg told
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NHI financing model questioned by FMF

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The latest iteration of the National Health Insurance (NHI) policy paper is no closer to defining how much the scheme will cost and where the money will come from to pay for it.

Meanwhile, SA risks running out of tax payers to finance its social security commitments, said Dr Johann Serfontein, senior healthcare consultant with HealthMan and Jasson Urbach, director & head of the Free Market Foundation’s Health Policy Unit.

The NHI scheme is based on a government administered, centrally controlled, single-payer model. Healthcare decisions will be determined by government from the cradle to the grave. NHI will reduce the number of available services, mean fewer healthcare providers and patients will face long waiting lists. NHI concentrates power in the hands of government and requires it to act as both player and referee, leaving no room for the private sector. Under NHI, whether directly or indirectly, government will control the availability, financing and
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Pharma’s role in the government’s National Health Insurance

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In its current form, the proposed National Health Insurance (NHI) is by no means perfect and there remains a lot of uncertainty around funding, medical skills shortages, the role medical aids will play and how infrastructural problems, wastage and corruption in the public sector will be tackled.

“Healthcare reform challenges all of us that operate in the sector to keep and expand our place at the table. It is becoming increasingly clear, however, that NHI is here to stay, which makes it imperative for pharmaceutical companies to get involved in the debate at the highest level in order to help shape a sustainable and effective healthcare system for South Africa,” says Erik Roos, CEO of Pharma Dynamics…
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Will the HMI insights get lost in the rush to finalise healthcare laws?

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Has the almost simultaneous release of the National Health Insurance (NHI) Bill, the Medical Schemes Amendment Bill and the provisional findings of the Health Market Inquiry (HMI) created an information overload, where some of the insights from the inquiry could be lost in the noise?

“There is significant risk that the regulatory environment being created through the legislative amendment process currently underway could conflict with the lessons learned in the course of the HMI’s work, which will only be fully apparent on the release of its final report,” says Mark Arnold, principal officer of Resolution Health Medical Scheme.

A considerable amount of time, resources and expertise have been invested in the HMI, but with the final report due for release in November, however, there is a risk that the full benefit of these insights could be lost due to the timing of these inter-related developments, as the period for submissions on Medical Schemes Amen
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These are the cheapest and most expensive medical aids in South Africa

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The latest GTC (formerly Grant Thornton Capital) Medical Aid Survey for 2018 has been released, which compares local medical aid schemes on cost to members across various levels of cover.

South Africa’s medical aid industry is facing an uncertain time ahead with government recently pushing through two new healthcare bills that are set to shake up the entire system ahead of the launch of the National Healthcare Insurance (NHI) scheme.

According to GTC, there are still many lingering questions that need to be answered in term of government’s plans – with many risks in the proposed changes that could lead to higher costs for consumers who rely of private healthcare.

“The NHI and amendments to the Medical Schemes Bill are inevitable. The disparity between the have’s (some eight million members) and the have-not’s (some 45 million) is real and needs addressing. Government intervention is urgently required,” it said.

“It is however equally importa
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