Submission on the Draft Medical Schemes Amendment Bill
The ALP welcomes the opportunity to make a submission on the draft Medical Schemes Amendment Bill (“the draft Bill”) in so far as it deals with risk equalisation. We do so against the following background:
- We accept that the health sector should operate on the basis of solidarity. In the private sector different groups with different health needs should not get treated unfairly within a scheme. In the public sector, all health users must be guaranteed a minimum basic set of health services.
- That the Risk Equalisation Fund (“REF”) – and other regulatory measures aimed at the privvate sector – must form part of broaders health care reform, including the development, adoption and implementation of National Health Insurance (NHI). This is essential if we are to work towards achieving a more effective and unified health system, and is also in line with the recommendation of the ‘Committee of Inquiry into the Various Social Security Aspects of the South African Health System’ (“Taylor Report”) as well as its mandate.
- We believe that the rationale of the REF, whcich is to ensure that all schemes bear the same risk in making prescribed minmum benefits (PMBs) available to their members, is a sound one.
- We therefore support the REF on the condition that it forms part of a broader set of regulatory measures to equalise risk across and within all sectors, not just the private sector.