The government’s proposal for a collective bargaining scheme for private healthcare providers has been described as flawed and unworkable, with calls for the plan to be dumped altogether.
In February, Trade, Industry & Competition Minister Parks Tau had published draft regulations to the Competition Act proposing medical schemes and some private healthcare providers be granted an interim block exemption to the Act’s prohibition on collective bargaining.
The draft regulations, which exclude private hospitals, also propose setting up a multi-lateral tariff negotiating forum which would be overseen by the Department of Health, reports BusinessLIVE.
However, the United Healthcare Access Coalition (UHAC), representing 34 healthcare organisations, said the scheme had not been properly thought through, nor was it aligned with the recommendations from the Competition Commission’s Health Market Inquiry (HMI).
The HMI’s final report proposed a set of inter-linked reforms that – apart from establishing an independent tariff-negotiating body – included interventions to manage demand, equalise risk between medical schemes, and monitor the outcomes of care.
“You can’t cherry-pick which parts of the HMI you want. If you introduce a partial approach, it is going to have a negative effect on all of the features of the market the inquiry identified as problematic,” said UHAC steering committee member Alex van den Heever, from the Wits School of Public Governance.
Managing health policy with an exemption to the Competition Act was a “highly questionable” approach and likely open to legal challenge, he added.
The regulations gazetted by Tau introduce a framework to assess treatment protocols, health technology and the quality of care, which goes beyond the scope of the Competition Act, he pointed out.
“These are health policy issues, which fall under the jurisdiction of the Health Minister and have nothing to do with trade, industry and competition. It is the Minister of Health who needs to establish a positive legislative framework to implement the recommendations of the HMI,” Van den Heever said.
The UHAC said the block exemption approach should be scrapped and the HMI recommendations implemented in full, including establishing an independent regulatory authority to oversee expeditious tariff-setting, with a structured multi-lateral negotiating body to ensure transparent and binding tariffs.
SA Private Practitioners Forum chair Simon Strachan, also on the UHAC steering committee, said the tariff-setting mechanism should include hospitals as they are a significant contributor to healthcare cost inflation.
The Health Department was refusing to establish a permanent system to manage and regulate private healthcare because it is so focused on implementing NHI, said UHAC steering committee member Aslam Dassoo, convener of the Progressive Health Forum.
“It is working on the assumption that somehow, in three years’ time, we will have a completely new healthcare system that replaces both the current public and private systems, and pays for everything. This is implausible. It is not going to happen,” he said.
See more from MedicalBrief archives:
New coalition awaits state response on reworked universal healthcare model
‘Piecemeal’ HMI implementation won’t bring down costs, say experts
‘Transitional’ private healthcare reforms punted ahead of NHI