Johannesburg - South Africa spends more on healthcare than
many other countries yet patient care is declining, Health Minister Aaron
Motsoaledi said on Friday.
"We exceed GDP (gross domestic product) of health care
costs.... We are a country spending more on health but having poor outcomes,"
he told delegates at the annual Competition Commission conference in
In 2009, the health expenditure in South Africa was 8.51% of
GDP, according to a World Bank report.
This was considerably higher than the 5% recommended
by the World Health Organisation.
Motsoaledi said uncontrolled commercialisation was
"consuming" healthcare in the country.
"Part of the reason for this is due to a lack of basic
essentials, caused in part by uncontrolled commercialism... whereby tenders
come first and healthcare comes last," he said.
Motsoaledi said inflation on items was costing medical aid
companies, including Discovery Holdings [JSE:DSY], about R2bn a year and had
resulted in escalated medical premiums.
In "desperation" medical aids were reducing
benefits "further and further", he said, adding that the regulation
of the private sector proved to be difficult.
An inquiry was needed to deal with this because healthcare
has to be customised to meet the needs of the patient.
"There is only one loser... and it's the patient...
when medical aids don't pay in full, the patient is still the loser... the
patient is always the loser," said Motsoaledi.
"In South Africa, we still think little of primary
healthcare... While premiums (of medical aids) are increasing, patient care is
He noted that due to the global economic crisis, many
countries were tempted to reduce social services, especially health.
"Health is a public good and not just any other
"I don't know any minister of health in the world who
is not worried about the affordability of health care."
He said health was not something that could recover because
if someone was ill, they might die.
Referring to the Declaration of Alma-Ata, the minister said
more needed to be done to make the dream a reality.
The Declaration of Alma-Ata was adopted at the International
Conference on Primary Healthcare in 1978.
It expressed the need for urgent action by all governments
and the world community to protect and promote the health of all people.
This was the first international declaration underlining the
importance of primary healthcare. It resolved to achieve "health for all
by the year 2000".
"This dream never happened," said Motsoaledi.
He said there are two types of healthcare: costly private
care for the privileged and second-rate care for everyone else.
"Medical aid schemes punish the poor... Health care is
simply becoming unaffordable to people in the world."
On the national health insurance (NHI), Motsoaledi said it
was not a beauty contest between the public and private sector. It was an
attempt to better the services to the people of South Africa.
The NHI is a financing system that aims to ensure citizens are
provided with essential healthcare, regardless of their employment status and
ability to make a direct monetary contribution.
Healthcare was becoming the focus of the work of the
Competition Commission, as it intends examining the private health system in
South Africa and abuse in the markets.
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