Medical schemes and hospital groups outline their COVID-19 policies

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As the number of confirmed coronavirus cases rises every day in South Africa, and the likelihood of more internal transmissions escalates, many people are starting to wonder whether they’ll get adequate medical attention should they be diagnosed, what their medical schemes would cover them for, and what will happen to those without health insurance as state hospitals are already in a state of dysfunction.

Fin24 reports that it asked medical schemes and private hospital groups what they are doing to cooperate with government in terms of covering testing and treatment and providing quarantine facilities, if the load of people requiring hospitalisation gets to a point where beds in the military hospitals aren’t enough to accommodate all those who need admission.

Fin24 asked the country’s three biggest open schemes who said they will cover testing and treatment.

Discovery Health Medical Scheme (DHMS), in line with many other medical schemes, has created a new benefit package to cover DHMS members diagnosed with the coronavirus, called the WHO Global Outbreak benefit. It covers all members on all plans where infections occur within South Africa, giving them access to diagnostic testing for both the coronavirus and influenza.

Bonitas Medical Fund will cover diagnosis, treatment and care for the coronavirus from the risk pool as well. And Momentum Medical Scheme said it will cover the cost of diagnostic tests and treatment and hospitalisation, where necessary, for all members from its risk benefits. 

The report says regarding hospitalising people with no medical aid – RH Bophelo, a JSE-listed group that has eight hospitals, said it had offered the Health Department a full isolation facility at a "huge discount", should government run out of capacity. "We’ve given them options of 50, 100 and 150-bed facility. My view is that right now, because most people have mild symptoms, we haven’t yet reached a crisis where we need thousands of beds. The demand for private beds is not yet there," said CEO Quinton Zungu.

The report says the big private hospitals have also offered their support. Netcare, which has 54 hospitals and over 10,000 registered hospital beds, said it is fully committed to offering support to the Health Department and the and National Institute of Communicable Diseases (NICD) as requested.

Mediclinic Southern Africa said it is actively engaged in regular discussions with players from different sectors to coordinate the provisioning of care for the South African public. "At this stage we continue to operate in our existing capacity. This stance will be reviewed regularly in industry forums as the COVID-19 situation evolves," said the company in an emailed response.

Health minister Zweli Mkhize is having sleepless nights about what would happen if the coronavirus started spreading through South Africa's vulnerable communities, reports The Times. In particular, he said he was concerned about how the virus – and the COVID-19 respiratory illness it causes – would impact on those who live in informal settlements, have HIV/Aids and tuberculosis and who use mass public transport networks.

“Things you learn in South Africa, you won't learn anywhere else. No-one has got 7m people who are HIV-positive and many who are on antiretrovirals. No-one has got as much tuberculosis as we have. No-one has got the kind of inequality and spatial inequality and distribution of poverty to one part of the country, with affluence to one side. No-one has got that,” he said.

So far, the virus has mostly hit those who are middle-class citizens who can afford private health care.

Mkhize said they were considering surveillance of areas where infections could spread. There, they would have health officials embark on “drive-by tests” – spot tests of anyone showing symptoms of the virus. Currently, the government has about 2,000 people who have been hired as tracers who work on tracing people who have possibly been in contact with those who have tested positive for the virus.

NHS England has block booked almost the entirety of the private hospital sector’s services, facilities and nearly 20,000 clinical staff for the foreseeable future to help cope with the surge of COVID-19 patients under an unprecedented deal, says a Health Services Journal report. The emergency agreement, only for the NHS in England, adds around 8,000 hospital beds, nearly 1,200 more ventilators, more than 10,000 nurses, 700 doctors and 8,000 other clinical staff.

Private sector providers said all facilities would be provided at cost price under the deal. The NHS said it would continue to fund the deal as long as it was needed.

NHSE said the extra capacity and resource “will not only be available to treat coronavirus patients, but will also help the NHS deliver other urgent operations and cancer treatments”.

An NHSE statement added: “The deal – the first of its kind ever – includes… over 2,000 hospital beds, and over 250 operating theatres and critical beds (in London).” The deal was brokered between NHSE and the private hospitals, via the Independent Healthcare Provider Network.

Full Fin24 report

Full report in The Times

Full Health Services Journal report

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