The National Department of Health has denied dragging its heels over plans to make the cost of healthcare more affordable, after the Board of Healthcare Funders (BHF) accused it of failing to act on several recommendations from the 2019 Health Market Inquiry aimed at reducing private healthcare costs.
“The Minister and the department have consistently cited the high cost … as one of the reasons why National Health Insurance (NHI) is necessary. Yet presented with an opportunity to make a tangible difference they’ve not even attempted to get out of the starting blocks,” said BHF MD Katlego Mothudi.
Five years ago the Competition Commission published its HMI report that recommended various steps to slash private healthcare costs. They included the setting up of a tariff negotiation forum between the private sector, allowing medical schemes to collectively determine prices with healthcare providers, which could reduce healthcare costs.
Another suggestion was to establish a supply side regulator to ensure pricing was determined transparently, reports Business Day, with the BHF saying the changes would ease the financial burden on medical scheme members, making private healthcare more accessible while reducing pressure on public facilities.
But there has been little discernible action from the government, said the BHF, leading to a growing gap between what medical schemes are willing to pay and what healthcare providers charge – and forcing patients to make high out-of-pocket payments.
The BHF has since formally requested a response from the Competition Commission regarding its 2021 application for an exemption from the Competition Act, allowing schemes to negotiate tariffs collectively with healthcare providers.
The BHF, which said this would improve transparency and ultimately lower costs for consumers, slammed the Commission for not exercising its own authority to grant the exemption, instead passing the buck to the Department.
In a recent presentation to the Health Portfolio Committee, the Commission said there had been four applications for exemptions on pricing, and that it was considering a block exemption.
“Instead of exercising its own legislative authority by granting the BHF’s exemption application, it continues to put the onus on the Department to address the current pricing vacuum,” said the BHF.
Block exemption could further delay action, as it would require co-ordination between the Commission and the Department.
Competition Commission spokesperson Siyabulela Makunga confirmed the Commission had received correspondence from the BHF. “We are prioritising the consideration …and will make a decision in due course,” he said.
The Department has had several meetings with the Competition Commission to find a solution to the matter of pricing, said spokesperson Foster Mohale. “These meetings have also included the Council for Medical Schemes (CMS).”
Mohale added that the HMI had recommended a schedule 3A SSRH entity, a government-run health organisation that provides medical services to the public, but the chances of this being approved were very low, “as Treasury has indicated it does not agree to more entities”.
“Some HMI recommendations will be incorporated into the various changes that will be brought about by the NHI developments (not all in the NHI Fund, but also in the Office of Health Standards Compliance, CMS and National Department of Health).”
He said the Department was in talks with the Competition Commission about the four exemption applications, but “we are not in a position to share the discussions especially while there are threats of legal action, and indeed commenced action”.
Business Day PressReader article – BHF rails at inaction on health costs (Open access)
See more from MedicalBrief archives:
NHI will cover Health Market Inquiry recommendations – Crisp
Health Funders Association welcomes Health Market Inquiry's report
Health Market Inquiry delay will impact on patients – Section27
Health Market Inquiry: ‘Nothing we don't already know', says Health Minister