Digital tracking systems used during the pandemic will drive the National Health Insurance – which “still needs a lot of work, and will require working with the private sector”, according to the Health Department's Director-General Sandile Buthelezi.
Speaking at the recent Board of Healthcare Funders conference in Cape Town, Buthelezi said the digital strategy would enable the government to access all patient records and track treatment outcomes. It would be linked to biometric identity systems at home affairs and monitor 55 000 healthcare facilities.
“The Covid vaccine system was a test of how we can use the private system and how it responded to the insured or uninsured. We can code where you came into the system and at what cost,” he told the conference.
He added, however, that the NHI still needed “a lot of work”, reports BusinessLIVE.
“It’s a long road and a phased approach as we go section by section and promulgate regulations.”
The disparities in healthcare pained him, he told the conference, and the department was struggling to employ more doctors as part of setting up NHI, but it was working in a “highly litigious environment”
“Every week there are new court papers on my desk.”
There was enough money to start the NHI, but it needed to be spent better. “Spending 13% of our GDP on healthcare when other comparable countries are doing better needs urgent addressing.”
Buthelezi listed an overhauled coding system, standardisation of data collection, capacity building to inform policy development and quality standards as among the key reforms required.
“The office of healthcare standards compliance is critical in putting patient safety at the centre. We’re also working with the Special Investigating Unit and our lawyers are cleaning up in the litigation forum.”
Buthelezi said the private sector would be “critical in whatever we’re going to do. We will procure from both sectors.”
He said during the Covid vaccination drive, connecting pharmacies to the digital network “almost cost me my job – but we had to save lives and it was a steep learning curve”.
“In future we’ll have proper contracting systems.”
The Government Employee Medical Scheme (GEMS) had significant capability that would be of great use for the NHI, he said.
“They have built capacity, but we must also bring in labour. We’ve signed a memorandum of understanding at the negotiating council to ensure this happens. We don’t want to lose any capability and skills.”
Mark Blecher, chief director for health & social development in the National Treasury, told the conference among the reasons NHI would take years to roll out, were the wide range of public sector reforms required in its early stages and the shifting of funds from provinces to NHI.
Other challenges included finding a way to form a common basic benefit package across public and private sector financing. Much medical scheme regulatory reform had been stalled for a decade or more, “waiting for an NHI”.
Blecher questioned “whether we should not be more active as a country” in dealing with regulatory reform, given that it will still take several years to roll out NHI.
He said reimbursement would have to be reformed, with primary care playing a greater role in implementing recommendations of the health market inquiry that reviewed the private healthcare market.
Short-term reforms that were “attractive to users” should be prioritised. These included identifying improved and more efficient care options.
BusinessLIVE article – The NHI revolution will be digital (Restricted access)
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