the emergency meeting with the private health industry
8 August 2007
I would like to thank all of you for taking some of your precious time to be
part of this meeting at such short notice. In our view, this meeting is a
continuation of a consultation process aimed at resolving some of the
challenges facing us in improving access to affordable and quality health
care.
We fully acknowledge the role of the private sector, alongside the public
sector, in the delivery of healthcare services to all our people as directed by
the Constitution of our country. At the same time, we recognise the need for
the private health sector to play a meaningful role, complementary to the
public health sector. It is an important relationship that has to be harnessed
to ensure that we meet the health care need of the people of South Africa.
Over the past few weeks, there have been numerous reports in the media on
certain undesirable and in some instances unethical business practises in the
private sector. I have also been quite concerned about what I have been hearing
from different stakeholders almost on a daily basis.
The consumer is the weakest player in all of this. These consumers are
complaining, correctly so, that their premiums are increasing but the package
of benefits is shrinking.
They are also concerned that they are increasingly compelled to pay more on
an out of pocket basis for consultation and drugs. Co-payments are rapidly
increasing with more and more benefits being subsidised by consumers.
As if this was not burdensome enough, consumers have to pay providers
directly and they are expected to thereafter claim from the medical aid,
instead of these two parties, providers and medical schemes settling the claims
directly. The question is why should this entire burden have to be carried by
the consumer who happens to be the weakest party in this sector?
I cannot help but emphasise that the practice of the out of pocket
expenditure pushes consumers further and further into poverty and this
undermines our broader objective of poverty alleviation as encapsulated in the
Millennium Development Goals (MDGs) and the Programme of Action of our
government.
If we are to make further progress on achieving these Millennium Development
Goals, the private health sector must show commitment in reducing the
catastrophic costs of ill health for these consumers.
Each time I have tried to raise the issue around cost in the private health
sector, one role player blames the other. As we were bringing down the price of
medicine including the issue of benchmarking, the pharmaceutical sector said
that they were not the main cost drivers and that we should be looking at other
role players.
Brokers have complaint that they are not paid enough and they have requested
me to adjust their fees from this month. Medical scheme administration costs
now exceed the cost of medicines.
Medical schemes are upset that the private hospitals and specialists have
reduced them to the level of price takers rather than price makers. Doctors and
private hospitals are also upset that medical schemes are reversing their
claims.
No one seems to be happy and this situation is untenable.
Ladies and gentlemen, the fact is that the national health system is for us
all and not for a few.
I am saying this precisely because, over the past years, we have introduced
measures to improve access to good quality and affordable private health care.
We are also incorporating these principles into the Health Charter which I hope
will soon be finalised.
It disturbs me to have to make this observation to an illustrious gathering
of our business community. But there is nothing so frustrating that there are
some shades of undesirable business practices that undermine our legislative
and policy framework and more importantly our people.
As the Minister of Health I have the responsibility to play a stewardship
role over the whole health system. This includes not only the public health
sector but also the private health sector. I have in the past stood back to
allow the private sector to sort itself out. Regrettably, there has been no
sign of progress in this regard. I have therefore decided to convene this
meeting to address these issues.
I honestly appeal to you all that we to work together as South Africans
towards the creation of the national health system that is caring and humane
and through which all South Africans must have access to affordable, good
quality health care.
From this meeting, we must agree on how we are going to address issues of
costs, affordability, access and sustainability in the entire health care
system. I call upon all of you to make recommendations on how the private
health sector can respond to the aspirations and the needs of the people of our
country.
I will now open this meeting for you to put forward your viewpoints.
Issued by: Department of Health
8 August 2007
