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2019/10/302019/10/07 09:31 AM

Verbruikers wat moeg gewag is op antwoorde oor die eindelose styging in mediese fondse se premies van bo inflasie, gaan hopelik Maandag antwoorde kry.

Die Mededingingskommissie het die markondersoek na die private gesondheidsbedryf reeds in 2014 van stapel gestuur ten einde ’n manier te vind om die skerp styging in die koste van private gesondheidsorg en die premies van mediese fondse onder bedwang te bring.
2019/10/112019/10/14 10:28 AM

The Health Funders Association (HFA), the representative organization of the majority of medical schemes and medical scheme administrators in South Africa, welcomes the comprehensive report of the Competition Commission’s Health Market Inquiry (HMI) and recommendations contained therein.

The report follows a thorough and extensive inquiry process.

Lerato Mosiah, CEO of HFA believes that, once implemented, the majority of recommendations contained in the report will provide a conducive environment for attaining universal health coverage.
2019/10/14 10:30 AM

Health Funders Association HFA, the representative organisation of most medical schemes and medical scheme administrators in South Africa, welcomes the comprehensive report of the Competition Commission's Health Market Inquiry HMI and recommendations contained therein.

Membership of the HFA covers 53 percent of medical scheme members across open and restricted schemes made up of 76 percent from open schemes and 21 percent of restricted schemes. The membership covers more than 4 4 million medical scheme beneficiaries.
2019/10/14 10:31 AM

Address NHI doubts before doctors leave SA While many doctors are in support of the National Health Insurance NHI scheme and its aim to make world class health care available to all citizens, some say they are unsure of exactly how they will be expected to fit in.

Four doctors two retired and two still working all experienced in the business of private practice, gave their opinions on the scheme that government aims to install by 2026, creating free quality medical care for all.

2019/10/112019/10/14 10:33 AM
NHI insert:

Mr Mboweni’s call for ‘credible and sustainable fiscal policy’ has also been jettisoned – if only through the National Executive Council's determination to push ahead with the National Health Insurance (NHI) proposal.

Health minister Dr Zweli Mkhize has recently suggested that annual tax revenues will have to increase by at least R250bn (the amount of private healthcare spending in the current financial year) when the NHI begins. This sum is more than the entire corporate income tax take (R220bn) in 2017/18, suggesting that substantial tax increases will in time be introduced.
2019/10/112019/10/14 10:35 AM

Provincial debt a clear sign that government would fail to run NHI successfully.

According to the Democratic Alliance (DA), implementing the National Health Insurance (NHI) bill would be a disaster for South African citizens.

The political party noted how the African National Congress-led (ANC) government planned on eliminating private healthcare in favour of NHI. However, seven out of eight provinces were said to be collapsing due to non-payment of invoices.
2019/10/14 10:46 AM

Tydens 'n operasie is 'n sker in iemand se ingewande agtergelaat. In 'n ander geval is die verkeerde ledemaat geamputeer. Dan is daar die pasgebore baba wat op sy kop laat val is…

Dis menslik om foute te maak, maar hierdie gruverhale van mediese nalatigheid is die soort nuus wat voorblaaie haal en ons gesondheidsdienste telkens in die beskul digdebank plaas. Daar word gese dat ons land se gesondheidsorg net agteruit boer. Dis gevaarlik om in 'n hospitaal opgeneem te word, word gekla.
2019/10/14 10:15 AM

Never before have South Africans been so engaged and mobilised on a matter as they are today whenever there are discussions around National Health Insurance. Sadly, the socio economic split is clear, making the NHI a divisive issue, just like racism.

This class divide is a feature of the recently published Health Market Inquiry (2019) report, which, among other things, says, (i) there is "poor stewardship of the private sector"... "as a consequence, the private sector is neither efficient nor competitive";( ii) there are industry monopolies of three hospital groups, i.e. Netcare, Mediclinic and Life; and ( iii) health professionals are incentivised towards the private sector even though they are all trained by the public sector.
2019/10/102019/10/14 10:27 AM

Once implemented, the majority of recommendations in the Competition Commission's Health Market Inquiry (HMI) will provide a conducive environment for attaining universal health coverage.

“These recommendations introduce mechanisms for progressive and positive changes to occur in the private healthcare market, such as moving towards alternative reimbursement systems and away from the traditional fee for service system, which has led to perverse incentives," Lerato Mosiah, CEO of Health Funders Association (HFA), says.

The recommendation for maximum tariffs for Prescribed Minimum Benefits (PMBs) is positive. However, Mosiah believes that in order to achieve this, funders and providers should come together to work on an industry wide single set of billing codes before the Supply Side Regulator for Healthcare is established, as suggested by the HMI. Clarifying the definitions of PMBs will also assist with this.
2019/10/092019/10/14 10:08 AM

The government should implement reforms to stabilise runaway prices after the department of health neglected its oversight role

The Competition Commission’s health market inquiry, which published its final report last week, has set out in meticulous detail what most readers of this paper instinctively know.

Patients are flummoxed by the complexity of medical schemes, specialists all want to be millionaires, and not even the dismal state of the economy seems to dampen the profit margins of JSE-listed private hospitals and medical scheme administrators.
2019/10/14 10:09 AM

The Competition Commission's health market inquiry, which published its final report last week, has set out in meticulous detail what most readers of this paper instinctively know. Patients are flummoxed by the complexity of medical schemes, specialists all want to be millionaires, and not even the dismal state of the economy seems to dampen the profit margins of private hospitals and medical scheme administrators.

The reason? Quite simply, the department of health long ago abdicated its responsibility to oversee the private health care sector, leaving patients to blunder through an opaque and poorly regulated system that siphons away an ever increasing slice of their household budget with no guarantee they will get decent care. Patients using the private sector admittedly do not have to confront the long queues, staff shortages and disintegrating infrastructure that hobble public health facilities, but they are subject to expensive and unnecessary procedures.
2019/10/092019/10/14 10:13 AM

FirstRand chair Roger Jardine says “government’s apparent unwillingness to champion the private sector as a growth engine is mystifying”. Writing in the 2019 integrated report of the country’s largest banking group by market capitalisation, he insists that “there is no plausible plan for South Africa to prosper without the private sector playing a strong role in creating sustainable growth”.

It is “time for government to partner with the private sector to drive the developmental agenda”, he says.

“The private sector has the incentive, skills and resources to build businesses that employ people and build the wealth of the country. It cannot, however, do it on its own. It needs a government that creates policy certainty, is not distracted by trying to keep failing SOEs [state-owned enterprises] afloat and/or running sectors of the economy that can be done more efficiently by the private sector.”
2019/10/092019/10/14 10:16 AM

As a strategic purchaser the National Health Insurance should be expressly pro-public sector and strategically focus on building capacity in under-resourced areas such as clinics and hospitals in poorer urban communities and in rural facilities.

When engaging in the discussion around the National Health Insurance (NHI), it is important to state, by way of introduction, a few key points:

First, that South Africa has inherited deep social and economic inequalities and as a result is in the grips of four major and concurrent epidemics: infectious disease; maternal and child morbidity and mortality; trauma and violence, and a growing epidemic of non-communicable diseases such as hypertension, diabetes and cancer.
2019/10/092019/10/14 10:18 AM

The ministers of Health and Economic Development hit back at Health Market Inquiry findings blaming the government for “inadequate stewardship” of the private sector and not doing enough to regulate private hospitals, doctors and medical aids. When government tried to regulate the sector, it was dragged to court, ministers Zweli Mkhize and Ebrahim Patel are quoted as saying, in a TimesSelect report.

A Times Select report says that the six-year-long inquiry, run by the Competition Commission, found there was “inadequate stewardship of the private sector with failures that include the department of health not using existing legislated powers to manage the private healthcare market, failing to ensure regular reviews as required by law and failing to hold regulators sufficiently accountable”. Chief Justice Sandile Ngcobo, head of the inquiry, complained that laws had not been implemented.
2019/10/14 10:19 AM

The Finance and Fiscal Commission says the timeline is too short to complete all the necessary steps to establish the National Health Fund

The government’s proposed deadline for establishing the National Health Insurance (NHI) fund is too short, the advisory body the state is required to consult with on revenue, warned parliament on Wednesday.

The NHI fund is a central pillar of the government’s plans for achieving universal health coverage, which promises to provide patients with care that is free at the point of service. The mechanism and timeline for implementing the fund is set out in the NHI Bill, which is currently being considered by parliament. It proposes that the fund be fully operational by 2026.
2019/10/092019/10/14 10:42 AM

The Health Market Inquiry Panel released its findings and recommendations report, following six years of investigation.

The National Education, Health and Allied Workers' Union (Nehawu) on Wednesday wants the Competition Commission to act against those implicated in wrongdoing in the private health sector .This after the Health Market Inquiry's final report alluded to collusion.

The Health Market Inquiry Panel released its findings and recommendations report, following six years of investigation.

The report painted a picture of an unaccounted private sector, where consumers are subjected to rising costs, without evidence of improvement.
2019/10/082019/10/14 10:05 AM

The Department of Health is working on a number of plans to ensure that the required skills are in place for the successful implementation of the National Health Insurance (NHI).

In an interview with 702, health minister Dr Zweli Mkhize said that this will include training up new doctors, and incentivising doctors currently in the private sector.

“You actually just train the people and get the people with the necessary skills. The skills are not only locked in the private sector,” he said.
2019/10/082019/10/14 10:07 AM

Almost six years after the Health Market Inquiry was instituted, the Competition Commission has finally submitted its report to the Trade and Industry Minister.

The commission has concluded that private healthcare is plagued by high and rising costs of medical cover, significant over-utilisation without a demonstrative improvement in health outcomes - and a “milking of the system” due to a lack of controls by the Department of Health.
2019/10/082019/10/14 10:11 AM

The prognosis is out – and for South Africa’s private health sector, it’s not a good one.

Yet another document containing directives for interventions in the private healthcare system has been added to the debate around the country’s healthcare system. This one targets the private sector and details the reforms that will be needed if government is to stand even a chance of getting the currently ailing sector in good shape for the full implementation of the National Health Insurance Fund (NHI) by the proposed date of 2026.
2019/10/14 10:37 AM

The National Health and Allied Workers Union Nehawu has slammed the Competition Commission over the recommendations of its Health Market Inquiry, saying it had let culprits off the hook.

This comes after the commission released the report into private health care, headed by former Chief Justice Sandile Ngcobo.

The report found the country's private health-care market to be highly uncompetitive, concentrated and dominated by only three players, while medial aid schemes were found to highly exorbitant to the disadvantage of health-care users who were paying more and getting less.
2019/10/14 10:39 AM

The National Health and Allied Workers' Union Nehawu has described the recommendations of the Competition Commission's Health Market Inquiry as weak and toothless.

This comes after the commission released the report of its investigation into private healthcare, which was started in 2013 and headed by former chief justice Sandile Ngcobo.

The report found the country's private healthcare market non-competitive, concentrated and dominated by only three players, while medical aid schemes were found to be exorbitantly expensive, to the disadvantage of healthcare users who were paying more and getting less.
2019/10/082019/10/14 10:41 AM

Congress of South African Trade Unions (Cosatu) largest affiliate – the National Health, Education and Allied Workers’ Union (Nehawu) – on Monday threw its weight behind the government’s National Health Insurance (NHI) Bill, pledging to make submissions to parliamentary hearings on the legislation.

Parliament has extended public submissions and comments on the NHI Bill from individuals and organisations until November 29.

The 274,000-member strong Nehawu, which also announced a programme of action on the NHI during a media briefing, said the legislation seeks to create a single purchaser, universal health coverage and an integrated health system.
2019/10/082019/10/14 10:43 AM

Health Minister Zweli Mkhize said on Monday when the National Health Insurance Fund is fully functional, it would become increasingly difficult for South Africans to afford private health care.

The department revealed only 15% of South Africans are currently on medical aid. Mkhize said government spent half of its healthcare budget on subsidising some small private health care groups through medical tax rebates.
2019/10/14 10:47 AM

Medical scheme members and their employers should brace for a 10% increase in their contributions in 2020, outpacing the annual general inflation rate by 4.6%, according to Aon SA, which advises employers on employer provided medical benefit costs.

This means your salary increase is likely to be lower than the increase in your contributions as it is more likely to be based on inflation, or lower if your employer is struggling.
2019/10/082019/10/14 10:49 AM

Schemes reject proposal to cap bosses' pay Tamar Kahn Science and Health Writer SA's two biggest medical schemes have rejected the notion of capping principal officer and trustee remuneration, which is among the recommendations made by the Competition Commission's health market inquiry in its final report released last week.

The scale of principal officer and trustee remuneration has been a concern for the Council for Medical Schemes CMS for several years, and the latest figures are laid bare in its 2018 2019 annual report, due to be presented to parliament on Thursday.
2019/10/072019/10/14 09:57 AM

There has been a lot of misinformation, misunderstanding and misinterpretation around the migration of Early Childhood Development (ECD) from Social Development Department to Basic Education Department and the introduction of the National Health Insurance (NHI) to achieve universal health coverage and offer quality health care services. To help close the information gap the ANC Gauteng Province’s PEC Subcommittee on Education, Health, Science and Technology will on Saturday (05 October) hold a workshop to give an update to stakeholders on the incorporation of ECD into Basic Education Department and to foster a better understanding of NHI
2019/10/14 10:00 AM

Die paneel wat die markonder soek na mediese koste in die private gesondheidsorgbedryf gedoen het, het sy "plig versuim" deur nie aan te beveel dominante hospitaalgroepe moet verdeel word nie, meen 'n kenner.

Pleks daarvan om op te tree om die twee dominante mediese fondsadministrateurs Discovery Health en Medscheme en die drie dominante hospitaalgroepe Netcare, Life Healthcare en Mediclinic te beperk is niks gedoen nie, se dr. Brian Ruff, uitvoerende hoof en stigter van die gesondheidsbestuursmaatskappy PPO Serve.
2019/10/072019/10/14 10:01 AM

The Competition Commission’s Health Market Inquiry report, released earlier in the week, paints a bleak picture of how corporates in that sector are writing their own profit cheques and mostly their own rules, too.

The inquiry, chaired by retired Judge Sandile Ngcobo, released the long-awaited report in Sandton and handed it to Economic Development Minister Ebrahim Patel and Deputy Health Minister Joe Phaahla.
2019/10/072019/10/14 10:36 AM

Competition Commission said to have failed to provide ‘recommendations with teeth’

The recommendations of the health market inquiry, released a week ago are problematic and need to be strengthened, the National Education Health and Allied Workers' Union (Nehawu) says.

Nehawu, trade union federation Cosatu’s largest affiliate with more than 280,000 members, said it was in talks with the Competition Commission with a view to giving the recommendations some sting.

At a media briefing in Johannesburg on Monday, the Nehawu leadership said the Competition Commission failed to provide “recommendations with teeth”.

Nehawu’s policy head Sidney Kgara said: “The recommendations are problematic. They were disappointing at many levels. They are coming up with a lot of bureaucratic structures instead of trying to streamline the integration of the health-care system.”

Nehawu general secretary Zola Saphetha said the inquiry was “lenient” with those who contravened the law, noting: “We are speaking to the Competition Commission to restrengthen them [recommendations] because we want to see consequences.” Saphetha said the private health-care sector was monopolised by three groups which meant they were able to “willy-nilly impose higher tariffs on patients in their narrow focus on profit margins rather than the health and wellbeing of the sick”.

“In this regard, the Competition Commission itself has failed in its duty in allowing mergers and acquisitions of smaller hospitals by these monopoly giants more than the years.”

The 256-page health-market inquiry report initiated in 2013 to probe increases in health-care prices in the private sector, found that the private health-care sector was dominated by three administrators: Discovery, Medscheme and MMI Health.

These collectively accounted for more than 80% of the administrator market, resulting in high barriers to entry. It was also found that Netcare, LifeHealthcare and Mediclinic accounted for 90% of the private hospital market, with Discovery Health medical scheme being the largest scheme in the open scheme market, followed by Bonitas.

The inquiry, chaired by former chief justice Sandile Ngcobo, recommended, among other things, that to improve governance and to align schemes’ interests with those of consumers, the remuneration packages of executives, principal officers and trustees be linked more explicitly to the performance of the schemes.

The schemes were called upon to encourage greater member participation in annual general meetings. The inquiry also noted that the “exclusionary nature” of provider networks could, in some instances, result in the exclusion of efficient competitors and raise the barriers to entry.

It was recommended that practitioners should have the option to opt-in or out of open networks provided they adhere to a predetermined notice period of between three and six months.
2019/10/072019/10/14 10:44 AM

South Africa’s healthcare landscape will change significantly once the National Health Insurance (NHI) comes into effect. But experts say medical aids won’t become obsolete.

While the NHI remains a work in progress in terms of policy and planning, medical aid members and schemes worry about the future. For now, at least not any time soon, nothing will change. As a 2017 NHI White Paper stipulates: until the new system is fully implemented and operational, things will stay business as usual.

The question is: What will happen to medical aid schemes once the NHI kicks in? According to Gerhard van Emmenis, principal officer of Bonitas Medical Fund, South Africa’s second largest open medical scheme, one of the first changes will be a decline in the number of medical schemes.

“From what I understand, once the NHI is a fact, there will be three or four medical aids left. These will serve as complementary health product providers and will fill the gaps left by the NHI,” he says.
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