Johannesburg, 30 September 2019 - SECTION27 and the Treatment Action Campaign welcome the publishing of the final report of the Competition Commission’s Health Market Inquiry (HMI). This has been an…
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.
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”.
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.
Netcare agreed that the HPCSA is dysfunctional and the issue is particularly concerning because the country has a shortage of health professionals. Netcare emphasised the limitations on private bodies to train professionals proposing that the inadequacy in training capacity indicates a need for private medical training.