Medical aid schemes, private hospitals under scrutiny

The audio is in isiZulu. See the English sumary below.

MABUTHO: Iningi labantu abangena ezibhedlela ezizimele kuleli bangamalunga ama medical aid schemes. Lokhu kungenxa yokuthi kuyabiza ukungena kulezizibhedlela uma kuqhathaniswa nalezo zikahulumeni. Kodwa ukuba phezulu kwemali ebizwa ngama medical aid schemes kwenza kube nzima kulabo abahola kancane ukungena kulezizibhedlela, nezithathwa njengezisezingeni eliphezulu. Lokhu sekuholele ekuthenini kungenelele ungqongqoshe wezempilo kuzwelonke, uDr Manto Tshabalala-Msimang. Ungqongqoshe uthi kudingeka kwenziwe okuthile ukuqinisekisa ukuthi lezizikhungo zezempilo ezizimele zisebenza ngendlela eyanelisa wonke umuntu wakuleli. UTshabalala-Msimang uthi umnyango wakhe angeke uqhubeke nokubekezelela amanani aphezulu abizwa ilezizikhungo zezempilo ezizimele.

DR MANTO TSHABALALA-MSIMANG: Private healthcare sector needs a coherent regulatory framework to ensure that it operates in the best interests of all the citizens of the country, not just its shareholders. We cannot afford to allow this industry to continue to be negatively affected by the cost spiral that we are currently witnessing.

MABUTHO: UTshabalala-Msimang uthi ukuze kulwiswane nesihlava sokubiza kwezikhungo zezempilo ezizimele kuzomele kuphinde kekubhekisiswe imali ebizwa ngama medical aid schemes. Uthi kuleminyaka emihlanu edlulile imali ebizwa ngama medical schemes kule yenze ukuthi labo abahola kancane bangakwazi ukuba ngamalung ama medical aid schemes ukuze bezokwazi ukungena ezibhedlela ezizimele. Ungqongqoshe uTshabalala-Msimang uthi kuzofanele kekubhekisiswe ukuthi ngabe ama medical aid schemes asazilandela yini izimiso zomthetho iMedical Schemes Act. Uthi ngokwalomthetho ama medical aid schemes kumele abhaliswe njengezinhlangano okungezona ezenzuzo.

DR MANTO TSHABALALA-MSIMANG: Over the past five years, membership of medical schemes has become both static and increasingly unaffordable, thus widening the gap between the high-income and the middle-income groups in terms of access to private health care. ‘€¦Medical schemes are registered as not-for-profit. We need to ensure that this legal requirement is met by all schemes to ensure their viability.

MABUTHO: Khonamanjalo iBoard of Healthcare Funders emele ama medical aid schemes kuleli ithi okwenza ukuthi amanani ama medical aid schemes abe phezulu kungenxa yokubiza kwezibhedlela ezizimele kanye nodokotela abazimele. Oyisikhulu esiphezulu kwi Board of Healthcare Funders, uDr Humphrey Zokufa, uthi ukuze kwehliswe imali ebizwa ngama medical aid schemes kumele kuqale kwehliswe leyo ebizwa izikhungo zezempilo ezizimele. Uthi okwamanje ama medical aid schemes asebenza esimweni esiwaphoqayo ukuthi abize imali enkulu ukubhekena nezindleko zawo.

DR HUMPHREY ZOKUFA: The system right now in the health care sector is designed in such a way that those who participate in it are incentivised to do things that have led (to) where we are now. It is not that the people themselves are bad. The people are just utilizing the system to do what they can do to increase their remunerations. And I am saying we need to then change the system.

MABUTHO: Ngakolunye uhlangothi uKurt Worral-Clare oyisikhulu esiphezulu kwinhlangano emele izibhedlela ezizimele kuleli, iHospitals’€™ Association of South Africa, uthi inhlangano yakhe ayimelene nokuthi   kwehliswe imali ebizwa izibhedlela ezizimele. UWorral-Clare uthi kodwa kumele kuqondakale ukuthi ziningi izindleko ezibhekene nezibhedlela ezizimele ezinye ezingaphezu kwamandla abo. Uthi lezindleko izona eziholela ekukhuphukeni kwemali ebizwa izibhedlela ezizimele. UWorral-Clare uthi kodwa ngeshwa labo abakhala ngokubiza kwezibhedlela ezizimele abazinaki lezozindleko.

KURT WORRALL-CLARE: There are many cost components to private hospitals, some of which are in our control, while others are not. Unfortunately when hospitals are asked to consider prices, little if any consideration, is given to the cost of delivering health-care services.

MABUTHO: Kubukeka kusazothatha isikhathi ukufinyelela esivumelwaneni maqondana nodaba lokwehliswa kwemali ebizwa izikhungo zezempilo kanye nama medical aid schemes. Lokhu kungenxa yokuthi kukhona ukukhombana phakathi kwama medical aid schemes kanye nezibhedlela ezizimele. Kanti okunye okungaba nomthelela ukuthi izikhungo zezempilo ezizimele zithi zinezindleko eziningi ukwenza nokugcina umsebenzi wazo ube sezingeni eliphezulu.

The English summary.

Medical aid schemes, private hospitals under scrutiny

Medical aid schemes and private hospitals have come under fire from the Health Minister for charging high fees.

Compared to the public health sector, private hospitals are highly-resourced and cater for high-income earners who happen to be members of medical aid schemes. The exorbitant fees charged by the schemes make it difficult for low-income earners to afford them and thus, can’€™t access private health care. This has forced the Minister of Health, Dr Manto Tshabalala-Msimang, to want to intervene.

‘€œPrivate healthcare sector needs a coherent regulatory framework to ensure that it operates in the best interests of all the citizens of the country, not just its shareholders. We cannot afford to allow this industry to continue to be negatively affected by the cost spiral that we are currently witnessing,’€ said Tshabalala-Msimang.

The Minister also raised concerns about the high fees charged by some medical aid schemes. ‘€ Over the past five years, membership of medical schemes has become both static and increasingly unaffordable, thus widening the gap between the high-income and the middle-income groups in terms of access to private health care,’€ Tshabalala-Msimang said. ‘€œMedical schemes are registered as not-for-profit. We need to ensure that this legal requirement is met by all schemes to ensure their viability’€, she added.

Representing the medical aid schemes industry, Dr Humphrey Zokufa, the Managing Director of the Board of Healthcare Funders, acknowledged the problem and said the current health care system is imperfect and allows some members of the private health care industry to conduct unethical business practices to ‘€œincrease their remuneratations”.

‘€œThe system right now in the health care sector is designed in such a way that those who participate in it are incentivised to do things that have led (to) where we are now. It is not that the people themselves are bad. The people are just utilizing the system to do what they can do to increase their remunerations. And I am saying we need to then change the system. ‘€ said Dr Zokufa.

Kurt Worral-Clare, the Chief Executive Officer of the Hospitals’€™ Association of SA, which represents private hospitals, agrees that there is need for change, but says there is lot more that needs to be done to bring down costs.

‘€œThere are many cost components to private hospitals, some of which are in our control, while others are not. Unfortunately, when private hospitals are asked to consider prices, little, if any, consideration is given to the cost of delivering health-care services,’€ said Worral-Clare.

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