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Hospitals, specialists drive up costs

Aug 14 2012 21:46 Sapa

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Johannesburg - The Board of Healthcare Funders of Southern Africa (BHF) has welcomed the health department's finding that hospitals and specialists are driving up medical costs.

Expenditure on private hospitals by medical schemes rose by 109.3% in real terms between 2000 and 2009, according to the Council for Medical Schemes' 2010 annual report.

"This equates to 37% of the approximately R84bn collected by medical schemes from their members," said the BHF in a statement.

"The refusal by hospital groups to provide data on the cost of providing hospital care to the BHF and others has meant that the only way of conducting studies on pricing is to obtain data from other countries for similar healthcare services," said BHF spokesperson Humphrey Zokufa.

The lack of transparency had also resulted in smaller medical schemes being charged higher hospital tariffs than bigger schemes.

Hospital groups formed an oligarchy and wielded market power.

Secondly, there were no set prices for healthcare services, allowing providers to charge at any rate they pleased.

The set of minimum benefits which medical schemes had to cover by law were mostly hospital- and specialist-based conditions.

A 2006 BHF analysis had shown that costs within JSE-listed hospital groups were consistently higher than those of independent hospitals.

However, no explanation had been offered for this discrepancy by hospitals.

"Hospital groups should not be defensive about these types of studies, but should rather be coming forward to explain as to how they will be making healthcare more affordable for the average medical scheme member," said Zokufa.

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