23 July 2019: Cape Town, South Africa: Interventions aimed at providing universal access to healthcare, such as the national healthcare insurance (NHI), must not be viewed merely as consumption expenditure, but rather as catalysts for human development and sustainable and inclusive economic growth, said Health Minister Dr Zweli Mkhize, presenting the keynote address yesterday at the 20th Annual Board of Healthcare Funders (BHF) Conference currently being held at the International Convention Centre, Cape Town, South Africa.
Dr Mkhize said, “South Africa spends 8.5% of GDP on health, while 4.5% is spent on 16% of the population covered by medical schemes. The Council for Medical Schemes (CMS) is the Regulator that is tasked with regulating the 78 medical schemes, 26 administrators, 15 managed care organisations on behalf of 8.8m beneficiaries. The medical schemes industry is very dominant, while covering 16% of the population. In 2018 alone, the industry paid out claims amounting to R172 billion, of which R15 billion is for non-healthcare costs and R62 billion for aggregated reserves. This is an inequitable and unsustainable situation, as the private hospital market is unaffordable and inadequately regulated.”
Despite 11 cents going to healthcare for every rand spent in the 2014/15 budget according to Statistics SA, only 16% of the population belonged to private medical schemes according to the 2015/2016 annual report of the Council for Medical Schemes. This means that the rest of the population depends on an overburdened public healthcare sector despite government spending substantially on that sector.
“The meeting provides us with an opportunity to reassess our progress towards the UHF goal by mobilising the highest political support for UHC whilst ensuring that no one is left behind,” says Dr Mkhize.
Reflecting on South Africa’s participation in the recent G20 Summit and the agreement made, the Minister emphasised that the successful implementation of NHI requires a partnership between public and private stakeholders in the healthcare sector.
“We view collaboration between the public and private sector role-players as crucial, guided by conditions in our country. This is in line with the commitment that we made during the Joint Session of Ministers of Health and Finance during the G20 Summit.
“Convergence will enable greater collaboration between the public and private sectors to revamp our ailing public health infrastructure. We intend to revitalise our infrastructure over a period of five to seven years, and this will be undertaken concurrently as we implement NHI. It will require that government employ creative strategies on financing mechanisms and alternative models of delivering the health infrastructure to meet the timelines.”
As government is bedding down the implementation of NHI in order to facilitate Universal Health Coverage (UHC), Dr Mkhize pointed out that Cabinet’s recent approval of the NHI Band Bill for tabling in Parliament and for public consultation paves the way for the Department of Health to establish an NHI implementation unit to provide support for the eventual implementation of NHI.
Correspondingly, he announced that a digital Health Patient Registration System is being developed to form the backbone of an electronic health patient record that is expected to be fully functional by the end of the financial year.
Dr Ali Hamdulay, Chairperson of the Board of Healthcare Funders (BHF) of Southern Africa, expressed the private sector’s willingness to support government in achieving the goals set out in the UN’s Sustainable Development Goals (SDGs) and National Development Plan (NDP).
“The National Health Insurance (NHI) in South Africa and the desire to achieve universal access to healthcare for all citizens continues to be the main strategic thrust guiding our country’s outlook and objectives for healthcare going forward, to meet the growing needs and demands for our people.”
Reflecting on a number of challenges that plagued the industry recently, Dr Hamdulay noted that the increasing burden of disease, high levels of healthcare utilisation, market failure components, lack of growth, rising health costs, and most recently allegations of racial profiling, have caused a rift between doctors and funders.
“The many years of hard work trying to bridge the gap between providers and funders have been undermined and our sector has become further polarised. Consequently, the overriding sentiment in our industry presently is negative and counter-productive to achieving mutually shared objectives for improving the state of healthcare in the country, and this must be addressed,” said Dr Hamdulay.
He said with just 11 years to the deadline on timeframes set out in the SDGs, the next decade presents immense possibilities and responsibilities for the healthcare community.
The Minister announced that the Health Compact in which many stakeholders in the healthcare sector participated has now reached a state where it is ready to be signed by the President on 25 July 2019. This Compact will commit stakeholders in the sector to work in concert to solve the issues affecting the healthcare sector, and progress in this regard will be monitored and reported on periodically.
“We need to find a formula that will enable us to achieve all our objectives,” said Dr Mkhize.
Putting into action efforts to collaborate to move the healthcare industry forward, the Africa Healthcare Federation (AHF) launched in South Africa during the BHF Conference and was officiated by Ms. Malebona Precious Matsoso, the Director General of the Department of Health (South Africa) and the Federation’s founding member Dr Amit Thakker from Kenya. The Private Healthcare Federation is a formalized platform of all healthcare stakeholders who will work with Government to deliver healthcare to all citizens via the NHI program. The founding principles to set up a Healthcare Federation in SA will include setting up a platform that will unify the private sector healthcare stakeholders, with the view of enabling collective perspectives and a common purpose towards driving the agenda for healthcare; and bridge the major divide between state and non-state actors in the healthcare sector. Participants in South Africa include the Independent Practitioners Association Foundation (IPAF); the Board of Healthcare Funders (BHF) of Southern Africa; the South African Medical Technology Industry Association (SAMED); South African Medical Association (SAMA); First Care; Sakhiwo Health Solutions; Ottobock; Lenmed; Allegra and Neuberg Global Laboratories.
Deliberations continue at the 20th Annual BHF Conference until 24 July 2019, with the conference seeking to reimagine the future healthcare systems in line with the conference theme Convergence 2030 – Healthcare Re-imagined.
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