The key goal of the 16th annual Board of Healthcare Funders’ conference is to come up with a roadmap to a sustainable future healthcare system. To this end, the conference is hosting various parallel sessions to debate the key issues and barriers to such a system with a view to coming up with concrete practical proposals that will take us from the system we currently have – fragmented, unsustainable, high-cost, stagnant in terms of medical scheme membership and of variable quality – to one that is sustainable, integrated and, above all, patient centric. This requires accountability throughout the system. “Healthcare is one of the key components of prosperity so an improved healthcare system is imperative to creating a prosperous society and country,” Dr Tebogo Phaleng, Executive Director at Coalesce, an independent health strategy advisory agency, told delegates. “South Africa is currently ineffective in achieving equitable access to health and protecting its citizens from the financial consequences of ill health. This cannot be allowed to continue. If it does, our children will certainly not have access to the healthcare we do at the moment.” The conference discussions mark the fourth phase in the journey towards this road map, further to a pre-conference survey, a gap analysis and a strategic think tank, which identified those areas of the current system that need re-evaluation. “The debates are intended to be collaborative, exploratory and iterative and will take place in a safe space for collaboration.”

South Africa can take a lesson from Costa Rica, which has one of the best health systems in Latin America. Further to giving its Ministry of Health a stewardship rather than a provider role in the late 1950s, the country expanded health coverage over four decades to embrace 90% of the population by the mid-1990s, albeit at high cost. Over the past 20 years a focus on primary health interventions has helped to reduce costs while maintaining standards, with funding directed according to needs, and the results speak for themselves. “A purchaser/provider split means there is no conflict of interest and the country has some of the best patient satisfaction statistics in the world.”

The envisioned overarching goals in the proposed roadmap are to work with government to create a more coherent, supportive legislative and policy framework and the building of trust relationships in the private healthcare environment. Various measures further to this will address the high burden of disease and improve life expectancy, in line with the National Development Plan. “In order to prosper as a nation, we need four key strategic interventions: good governance and strong institution of accountability; healthy competition in the industry; expanded access to healthcare and expanded access to education,” he concluded.

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