The government will table draft legislation intended to regulate the private health sector, including private hospitals, within two months, Health Minister Manto Tshabalala-Msimang said on Wednesday.
”It is clear that we cannot sustain unregulated private healthcare service delivery in this country and at the same time regulate the medical-schemes industry,” she told the National Assembly.
”We must therefore regulate the providers and the industry as a whole.”
The department has been working to draft legislation to present to the Assembly that ”will enable us to contain costs, prevent bad business practices and protect the consumer.
”I hope to table this draft legislation within the next two months for debate.”
Tshabalala-Msimang said she was shocked to hear at a meeting with the medical-schemes industry recently that they were by and large forced by the private hospital groups to enter into agreements on tariff increases, even though they felt that the demands of the hospitals were not justified.
”They reported that the attitude of the hospital groups was: if you don’t like the increases, pay us whatever you want and we will recover the balance from your members.
”This of course pits the member against the medical aid as the hospital will inform the patient that her/his medical aid has refused to pay the required tariff and that the hospital therefore has no option but to bill the patient directly.
”Madam Speaker, it is therefore clear that the playing field is not level,” Tshabalala-Msimang said.
”Some may ask why we are so worried about the private health sector, which only provides care for 15% of the population.
”The answer to this question is simple: the private sector is part of the national health system. What happens in this sector affects the entire health sector.
”When, for example, a person cannot afford private healthcare any longer because of the cost escalations, they turn to the public sector, thus increasing the number of people that are dependent on the public health sector.
”As well, the government must protect the interests of all its citizens, including those that use the private health sector,” she said.
The private healthcare sector provides care for about seven million people, or close to 15% of all South Africans, but consumes more than the total expenditure by the public health sector.
The per capita expenditure in the private health sector is about eight times more than that in the public health sector.
The private sector spends an estimated 5,5% of gross domestic product.
In addition, this sector employs more doctors, pharmacists and dentists than the public health sector.
”Clearly, this level of inequity cannot be left unchallenged.”
By increasing tariffs the private sector will add to this high level of inequity by making private healthcare services even more inaccessible to insured and self-paying patients.
Typically, people pay for private healthcare through membership of medical-aid schemes.
A number of people pay exclusively out of their own pockets.
As the costs of private health increases, the cost of medical-aid membership also increases, Tshabalala-Msimang said.
The announcement was met with mixed reaction from the various parties, ranging from cautious approval to calls for freeing the market, improving the state of public healthcare and implementing the proposed national health insurance system. — Sapa