Ongoing delays in the Health Market Inquiry impacts right to health

The findings and recommendations of the HMI are critical to the public debate on the National Health Insurance and the Medical Schemes Bills, and thus it is critical that these findings are made public as a matter of urgency. 

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HMI will not consider OECD study

The study was roundly criticised by the South African hospital groups and funders such as Discovery Health, particularly on the grounds of what were described as technical and methodological flaws. Discovery, Mediclinic and Netcare made further written submissions to the HMI, criticising the study and its conclusions.

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Bonitas: Medical schemes are expensive

Bonitas explained that there has been an increase of approximately 52% in the cost per year, per beneficiary in terms of PMB claims. It added that the proportion of PMB claims in hospitals had increased more rapidly than for services provided outside of hospitals.

The explanation Bonitas proffered for this was “upcoding” by healthcare professionals, because schemes must pay on invoice in full and that “the PMBs have made South Africans Hospicentric”. The result is that “most of our members actually end up in hospital”, which Bonitas’s representative plainly admitted “is a problem”.

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Make private health “more human”

Demand, the FDoH submitted is related to want which can be created whereas need is related to, amongst other things, burden of disease and availability of healthcare services. Demand for private healthcare is higher in Bloemfontein than anywhere else, with result that there is excess capacity in terms of beds. This happens at the same time as the need is high in poorer more rural areas, but the demand is lower because people are less able pay for private healthcare.

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