Posted on October 05, 2011
The cost of healthcare is more ruthlessly profit-driven than it was during the apartheid era, Health Minister Aaron Motsoaledi believes. Competition between medical aids was still ferocious, he said yesterday. During apartheid, an emergency patient would first be stabilised before being transported . to the appropriate health facility whereas now it is a "money first or you die" situation. "It's more brutal than what it was during apartheid... we need to change from that," he said. He said the situation had progressed from a two-tier healthcare system based on race during apartheid to a two-tier healthcare system based on socio-economic status where if you don't have money, you die. Motsoaledi was speaking in Joburg at a Gordon Institute of Business Science discussion on the controversial National Health Insurance (NHI) - an ANC-driven policy proposal aimed at broadening health access to the poor by overhauling the current funding model.
Motsoaledi said the NHI's purpose was to narrow the gap between private and public primary healthcare. Speaking about the private healthcare system and the exorbitant costs involved, he said a 2004 Competition Commission ruling that scrapped collective bargaining between medical aid schemes and service providers had not done anything to ensure reasonable pricing through competition. The ruling found that medical aid schemes and service providers had colluded in setting tariffs that contravened the Competition Act. "The ruling of the Competition Commission in 2004, we think, has led to the destruction of the healthcare system... The fact that they allowed a situation where there's no price control, a free-for-all, has put us in this situation where we have to fight against each other. We believe the (private) healthcare system is at best destructive, unsustainable, very expensive and curative, and we need to change that," he said. Motsoaledi wouldn't be drawn on the cost of the NHI, saying it was premature at this stage, but said the groundwork required to implement the NHI was progressing. So far, 2 000 of the 4 000 public healthcare facilities in SA had been audited to determine what was working and not working within the institutions. An office of health standards compliance was being established to certify health facilities that met NHI requirements. The minister said the first five years would be dedicated to overhauling the healthcare system.
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