Between 75% and 80% of South Africans have limited or no access at all to health services, Minister of Health Manto Tshabalala-Msimang said on Monday.
This inequity in health care is limiting access to medical treatment, she told delegates at the presentation of the draft Charter of the Public and Private Health Sectors of the Republic of South Africa.
The charter aims to transform the health sector to ”remedy the wrongs of the past” — by improving access, equity and quality in health care, as well as levels of black economic empowerment.
She said the costs of a recent shoulder operation showed her how expensive it is becoming to get rid of pain.
”I could not believe it. It is just incredible how unaffordable health care has become.
”If I can tell you how much I paid for that shoulder operation, you will be shocked. It just finished my medical aid — something is wrong.”
Tshabalala-Msimang said health care needs to be developed in the context of ”us being Africans”.
”Surely we can’t act as though we are Americans.”
According to the draft, health-care expenditure in South Africa was approximately R107-billion in 2003/04 — equivalent to 8,7% of gross domestic product in that year.
This provides a strong basis for arguing that the key challenge is not necessarily inadequate resources, but inequitable and inefficient application of resources, the document reads.
In 2003/04, medical schemes spent about R8 800 per beneficiary, while in the public sector it was R1 050 for people not members of medical schemes.
Inequity was also skewed geographically, in favour of the urban and private sector.
R33,2-billion in the public sector was serving 37,9-million people, whereas in the private sector R43-billion was available for 6,9-million people.
Kamil Chetty, chairperson of the team that drafted the charter, said private medical aids are becoming unaffordable, with access to medical schemes diminishing.
Between 1997 and 2003, ward fees increased by 45% and theatre fees by 94%.
”Twenty-five percent of health expenditure is out-of-pocket payments,” she said.
During the open session, Barry Swartzberg, MD of Discovery Health medical aid, said similar inequities exist in almost every industry.
”People in the private sector are spending money from their own pocket — it is their choice.”
Director General of Health Thami Mseleku countered with: ”Government is obliged to ensure that those citizens are also protected, otherwise it is a laissez-faire situation.”
The deadline for comment is August 15. Thereafter, the charter will be finalised and submitted to the Cabinet.
The charter, which is not a legal document, includes proposals such as contracting private practitioners to the state, using resources more efficiently through public private initiative, sponsoring training for health-care professionals, and developing low-cost finance options.
It also aims to have a 60% black workforce by 2010, half of which should be women.
Thirty-five percent of the firms or businesses in the health-care sector should be owned or controlled by black people and 60% of procurement should be from black-owned firms or people. This should increase to 80% by 2014. — Sapa