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Trends in Private Healthcare Funding as a result of current tariff structures

Board of Healthcare Funders Of Southern Africa. Trends in Private Healthcare Funding as a result of current tariff structures. 27 th July 2011 Portfolio Committee on Health :Cape Town Presented by: Dr H. Z. Zokufa and Dr C Mini Chairman and Managing Director of BHF. Contributions.

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Trends in Private Healthcare Funding as a result of current tariff structures

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  1. Board of Healthcare Funders Of Southern Africa Trends in Private Healthcare Funding as a result of current tariff structures 27th July 2011 Portfolio Committee on Health :Cape Town Presented by: Dr H. Z. Zokufa and Dr C Mini Chairman and Managing Director of BHF

  2. Contributions Investors Investors Private Healthcare Funding 2009/10 99 Medical Schemes 8.2 Million members R84.8billion R76.3 billion payment R2.5billion deficit Providers of Healthcare Private Hospitals Medical Specialist General Practitioner Pharmacists Nurses Physiotherapists Allied Health Traditional Healers Healthcare Products Pharmaceuticals Medical devices Surgicals Medical Equipment SA Constitution • Government Healthcare Policies • Legislation • Medicine and Related Subst Act • National Health Act • Medical Schemes Act • Pharmacy Act • Nursing Act • Health Professions Act • Traditional Health Pract. Act • Competition Act • Consumer Affairs Act

  3. Health benefits paid in 2009

  4. Trend in Healthcare costs

  5. Contribution rate changes

  6. Trend in number of beneficiaries

  7. GAPS IN THE S.A. HEALTHCARE SYSTEM • No robust quality assurance and assessments systems linked to cost • No robust health technology assessment • No meaningful peer review processes • Inadequate regulatory controls to protect the consumer • No perfect market in healthcare • Behaviour of entrepreneurs • QUESTIONS • Can sector take care of itself? • Is the consumer adequately protected? • Is the sector having the interest of SA citizens at heart? • Are the models, systems and processes in place appropriate? • Who can intervene ?

  8. Concluding Remarks and Proposals • There is a gap in the system – fully exploited. • There is unacceptable fragmentation. • The ordinary consumer is vulnerable. • Modelling of healthcare as an ordinary commodity. • Applying brutal business principles to healthcare as an ordinary commodity. • Getting sick - ? tipping point for poverty. • The Minister of Health must intervene – Section 27 of the Constitution • Legislative framework for healthcare prices control. • Reversal of Competition Commission ruling of 2003. • All the spheres and arms of Government must support this. • Introduction of National Health Insurance (NHI). • Healthcare Quality measurements.

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