{"id":254669,"date":"2018-06-27T13:09:38","date_gmt":"2018-06-27T11:09:38","guid":{"rendered":"https:\/\/businesstech.co.za\/news\/?p=254669"},"modified":"2018-06-27T13:09:38","modified_gmt":"2018-06-27T11:09:38","slug":"5-things-wrong-with-governments-massive-medical-aid-changes-da","status":"publish","type":"post","link":"https:\/\/businesstech.co.za\/news\/government\/254669\/5-things-wrong-with-governments-massive-medical-aid-changes-da\/","title":{"rendered":"5 things wrong with government’s massive medical aid changes: DA"},"content":{"rendered":"

Health minister Aaron Motsoaledi presented the National Health Insurance Bill and the Medical Schemes Amendment Bill to the media on Thursday (21 June), providing the legal framework that the government will employ to create a single healthcare service in South Africa.<\/p>\n

Motsoaledi said that bills will pave the way for more access to medical healthcare through National Health Insurance (NHI), and represent a massive shake-up to both the governmental and the private healthcare systems.<\/p>\n

However, the Democratic Alliance said on Wednesday (27 June) that, while it acknowledges and affirms the need for universal healthcare, it does not believe the proposed bills provide a workable model to achieve it.<\/p>\n

“Worse still, we believe the bills are little more than an attempt by the ANC government to co-opt private sector healthcare and its clients to remedy the rapidly failing public sector healthcare. Sadly, it will prove fatal for both,” said Patricia Kopane, DA shadow minister of health.<\/p>\n

She called the proposed creation of a single National Health Insurance Fund “little more than the creation of another enormous state-owned entity (SOE)”.<\/p>\n

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Read: What the new National Healthcare Insurance Bill says about who will pay \u2013 and where medical aids still come in<\/a><\/strong><\/p>\n

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The DA pointed to ‘many concerns’ around the plans, including questions over financial viability; the risk of a medical skills drain; the massive potential for institutionalised corruption; the absence of a plan to address the already failing public healthcare service; and the lack of adequate public participation in decision-making.<\/p>\n

Financial Viability<\/strong><\/p>\n

The DA said that minister Motsoaledi has already admitted that the cost of NHI is unknown. The White Paper on NHI, published in 2017, used a 2010 expenditure figure of R256 billion projected for 2025.<\/p>\n

This figure was under-researched at the time and is now woefully outdated, it said.<\/p>\n

The Davis Tax Committee indicated in 2017 that the NHI would be impossible to implement without significant economic growth. Meanwhile, Gross Domestic Product (GDP) growth figures for the first quarter of 2018 showed that the economy contracted by 2.2% – the highest quarter-on-quarter contraction in almost a decade.<\/p>\n

“Although cross-subsidisation is a well-established principle, the NHI threatens to further burden taxpayers now tasked with supporting those who are not capable of making an equal contribution,” Kopane said.<\/p>\n

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The medical skill drain<\/strong><\/p>\n

Kopane also expressed concern over a medical skills brain-drain.<\/p>\n

“The biggest reason cited by doctors leaving South Africa\u2019s public sector is the generally poor working conditions in public institutions. South Africa already suffers from an atrocious public doctor-patient ratio, and it we can ill-afford a similar exodus of medical professionals from the private sector, especially those in specialised fields.<\/p>\n

“Many medical organisations have already indicated that they believe that NHI will affect them negatively and some have already indicated that they will leave South Africa if NHI is implemented, which South Africa cannot afford,” Kopane said.<\/p>\n

The NHI and Medical Schemes Amendment bills propose price controls in the private sector, including a national price list which will punish those medical professionals who do not follow the prescribed pricing list. “Considering that government will be the largest purchaser of healthcare services, allowing it to set the tariffs as well is preposterous,” she said.<\/p>\n

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Institutionalised corruption<\/strong><\/p>\n

Kopane called it ‘ironic’ that the two bills were gazetted precisely at the same time as the Special Investigative Unit (SUI) report revealed the scope of corruption in the Gauteng Health Department.<\/p>\n

“Institutionalised corruption is already a feature of public healthcare in South Africa. With the NHI proposing to make the state the sole purchaser and financier of health services in the country, the potential for corruption is boundless and terrifying.<\/p>\n

“It has become clear that government is incapable of exercising any control over the wanton maladministration that is rife in the South African public healthcare.<\/p>\n

“If the NHI is implemented and the budget increased by hundreds of billions of rand, institutionalised corruption is sure to spread to the entire South African health system.”<\/p>\n

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Failing public service<\/strong><\/p>\n

The DA said that the country’s healthcare institutions have been grossly mismanaged and are persistently hampered by broken equipment, medicine shortages and insufficient numbers of staff.<\/p>\n

“A mere 6% of public health facilities passed their inspections on criteria ranging from drug availability to infection control. An Office of Health Standards Compliance report indicated that only five out of 696 inspected facilities in Gauteng achieved over 80% compliance with the nationally set norms and standards.<\/p>\n

“This must be considered with South Africa\u2019s doctor-patient ratio of 0.8 per 1,000, which is the worst of all BRICS nations. The minister has failed to indicate how the current deteriorating healthcare system will be improved to fulfil the NHI\u2019s mandate,” she said.<\/p>\n

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Lack of adequate public participation, openness and transparency<\/strong><\/p>\n

The NHI Bill creates a number of Ministerial Committees who aid in the establishment and management of the National Health Insurance Fund. The \u2018Benefits Advisory Committee\u2019, as established by section 25 of the bill, is tasked with determining and reviewing health service benefits and types of services to be reimbursed at each level of care at primary health care facilities and hospitals.\u00a0Kopane said.<\/p>\n

“However, this body fails to include representatives from civil society or labour that may aid in meaningful and effective decision-making.<\/p>\n

“The bill also does not seem to make room for adequate and meaningful public participation in the numerous of Committees it seeks to establish. Additionally, the proceedings in these committees should be open in order to guarantee transparency, accountability and good governance.”<\/p>\n

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The DA\u2019s plan<\/strong><\/p>\n

The DA said it has launched a plan for universal healthcare in South Africa, titled ‘Our Health Plan (OHP)’.<\/p>\n

“We believe our offer is the most credible and workable option that seeks to ensure that no person is denied quality healthcare because they are poor,” said Kopane.<\/p>\n

“For South Africans who have no medical aid, these reforms will herald improved service at clinics and hospitals, enhanced maternal and child care provision and access to efficient emergency services in urban and rural areas, free at the point of service.”<\/p>\n

Kopane outlined the DA’s health plan, which includes:<\/p>\n