Based on thorough local and international research, Mediclinic will contribute constructively to further development of a National Health Insurance scheme (NHI).
“As a company, Mediclinic Southern Africa supports the philosophy behind the NHI and the policy objectives, which are very sound. We support any initiative to increase access to quality healthcare for South Africans,” stated Mediclinic CEO Koert Pretorius at a recent media forum in Gauteng following the release of the NHI Green Paper in August.
Despite many generalisations about the private sector, the Green Paper also contains many positive statements about the quality of care in the sector as well as the need for a private sector in South Africa going forward, Pretorius stressed.
Mediclinic Southern Africa’s Funder Relations and Contracting Executive Roly Buys added that the Green Paper embodies commendable pragmatism and that inclusive process district-based piloting is a practical approach. There is also a clear indication in the Green Paper that the NHI will be rolled out over time as capabilities are developed.
“It’s also important to understand that it’s only through the process of systematic and constructive review, as well as a scientific analysis of the research available in the world, that we can come forward with the best possible solutions to suit our needs and demographics,” he argued.
Reiterating that Mediclinic supported quality healthcare for all, Buys pointed out that private hospitals in South Africa have a capacity that has been developed over the past 25 - 30 years, hence they can help improve efficiency, healthcare, training and administration in partnership with public hospitals to pass on these skills and thus share in the developmental phase of the NHI. Mediclinic and other private hospitals can also assist in providing quality healthcare for all by providing services to public patients without compromising quality.
“Highlighted in the document is essentially the understanding that you need both parts: the public healthcare sector and private healthcare sector must co-operate to realise the quality healthcare vision. To achieve this, it’s very important that all key stakeholders must be part of the solution.
“The private sector has unique understanding and skills, and these need to come into the process. So, we would ask for another process of transparent negotiation, discussion and debate of what should be included to find the optimal solution,” he explained.
According to Buys, in view of economic and healthcare needs in South Africa, a multi-tiered healthcare system should seriously be considered. This will ensure access in a way that’s affordable for all. In fact, in all the multi-tiered systems abroad, for example in Mexico, there is a prominent place for the private sector.
Other healthcare issues within the healthcare domain needing equal attention are the upgrading of public hospitals, but more importantly the development of human resources. “At the same time as the NHI is being developed, we should be aggressively working on the HR strategy to make sure that we have the numbers when we start the roll-out process.”
Clarity, however, is needed on a number of issues such as overall cost, the value of the proposition and benefits, co-payments, calls for ongoing monitoring, evaluation input and possible adjustments. Furthermore, details on the service offering, benefit packages, and funding mechanism are lacking.
Buys added that there is a certain level of paradox regarding medical schemes insofar as their tax subsidy will be removed. “We would believe that this would be an important part that has to be maintained in the development and maintenance of medical schemes,” he argued.
It’s also critical to find the appropriate funding models. “Comment time allocated is short and this creates concern. Also, the proposed pricing framework is complicated and must be independent and neutral. Hospital reimbursement reform must also be clarified. In addition, clarity and an undertaking about the tax burden on individuals is required. All of these issues should be discussed in a transparent and consultative process before we can move forward,” he suggested.
But while many issues around NHI still need to be clarified, “Mediclinic remains committed to working on the Green Paper, and is excited about finding a future where private healthcare contributes to the healthcare of the entire population,” Buys stressed.