Putting the health citizen first – what this means for Universal Healthcare Coverage

Author: BHF   Published: 2018-04-13

Source: BHF

The relationship between healthcare service providers and the health citizen has conventionally been transactional. Even with chronic health citizens, healthcare service providers have built a relationship of dependence. Putting the healthcare citizen first, pushing boundaries of the possible explore ways in which to deliver healthcare services with the health citizen as the number one priority.

As healthcare systems around the world move towards achieving Universal Healthcare (UHC) much research has been conducted on what needs to be done relating to policy evidence; however, not so much on how this will be achieved.

The 19th Annual Board of Healthcare Funders of Southern Africa Conference will focus on what can be done to move beyond technical policy evidence towards an action plan driven through participation, collaboration and implementation.

“We’ve heard a lot about why universal healthcare coverage would be impossible to implement, what we cannot do, and why we cannot do some of the things. It’s time the industry looks at what is possible, what can be done to implement those pockets of possibilities without having to change regulations or legislation. It’s about identifying the low hanging fruits and kick-starting practical steps towards universal health coverage,” says Dr Katlego Mothudi, Managing Director of the Board of Healthcare Funders of Southern Africa (BHF).

He said, “The narrative about the introduction and implementation of universal healthcare coverage in southern Africa has always been that it is unaffordable, government systems are collapsing and are not geared to delivering UHC. Yet we forget the pockets of success in countries such as Rwanda, which ranks as one of the most successful universal healthcare coverage programmes in Africa, including lessons from Ethiopia and Ghana that have also achieved significant milestones in the progress to delivery of universal healthcare coverage.”

While these are pockets of success, the examples go to show that universal healthcare coverage for Southern Africa and for Africa is possible.

He highlighted that we can deliver universal healthcare in Southern Africa, but first we need to remove the barriers that we have created in our thinking about UHC. We need to look at what can be done now, without waiting for regulatory reform, and push the boundaries of what we have deemed impossible to realise workable solutions in the delivery of universal health coverage.

“The healthcare sector’s priority should be ensuring that healthcare delivery is more member-centric and not service provider focused. Efforts must be made towards ensuring that the end product delivered to the ‘health citizen’ meets their healthcare needs,” says Dr Mothudi.

According to the BHF, there is a lot that medical schemes can do, working together with governments across the region, without having to wait for regulatory reform to begin driving the implementation of UHC.

Some of the current challenges in universal healthcare include cost escalation, reduced access and poor or non-standard quality of care. For the insured, without a doubt, medical aid contributions required to purchase healthcare are very high, and out-of-pocket payments are increasingly becoming a big challenge to the health citizen. Benefits schedules are also so complex that members don’t know benefits to which they are entitled.

A common view among the insured is that while contributions are high, there aren’t enough benefits to justify the costs.

For the uninsured, of concern across the region is adequate access to healthcare services as well as the quality of healthcare received.

Across the board, health citizens do not know what to expect from their healthcare providers and also don’t know what to measure quality care by. As a result, they cannot benchmark to determine whether they are receiving the best available healthcare services or not.

“There needs to be adequate consultation and informed consent to empower the health citizen with appropriate information to influence their choices and compliance to the healthcare services provided to them.

“Information prioritisation must focus on empowering the health citizen; there is a need to create awareness of the drivers of costs, cost of services, to create an understanding of the impact of fraud on the health citizen, the impact of choice of care, as well as an understanding of treatment modalities.

Across the region and continent, there is inadequate accountability for the quality of health care. New technologies come into the country and into the region unvetted. There is a lack of standardisation of healthcare measures, which raises the question: whose interests does the healthcare sector seek to serve? If it is for the healthcare citizen, we would be more cautious about these things.

A multi-disciplinary approach to healthcare delivery and regulation alignment will enable a seamless implementation of universal healthcare across the continent.

“This can only be attained through industry collaboration with all the stakeholders in healthcare in order to truly deliver to the needs of the health citizen,” says Dr Mothudi.

The 19th Annual BHF conference will be held at Sun City, from 17 to 20 June 2018.

Source: BHF