"Private health care is not affordable, even for supposedly rich people"

The findings of the Commission's Competition Health Survey released today reveal what Health Minister Aaron Motsoaledi is already saying: private health care has become so expensive, even those who need medical help. the commission found – during its investigation of more than four years – that the market was characterized by high and rising costs of coverage of health care and medical schemes, poor and uninformed consumers and a general lack of 39, value-based purchases.

"That private health care has become more expensive and more expensive has been proven today, some of us already knew in 2009 that private health care is no longer affordable, even for people who are supposedly rich and who can not afford it. " Motsoaledi said at the meeting held in Sandton to announce the release of the long-awaited interim report.

According to the chairman of the investigation, former Chief Justice Sandile Ngcobo – who presented the report's summary – the private sector health care market posted ever higher premiums, accompanied by increased direct payments for insureds, almost stagnant growth in hedges and a gradual decrease in the depth of services covered by the plan options.

"It is widely believed that the private health care sector provides better quality care than the public sector, but this is difficult to objectively badess because the South African private market does not have standardized means to measure and compare the quality of health care services or their results.The report of the survey noted:

Although there were 22 open plans, two medical plans make up 70% of the total market for open plans and the Discovery Health medical system includes 55% of the open plan market.The government employee medical plan (GEMS) was the second largest restricted plan.

There were 16 medical plan administrators and Discovery Health and Medscheme accounted for 76% of the market on the basis of gross contribution income.

"While marketing is important in the plan market, consumer Matters are not able to compare the offers offered. With about 270 plans on offer, consumers can not compare them and they can not choose diet and diet options based on value for money, "notes the report

. the offers were bundled, packaged and evaluated, which allowed the medical plans to weaken or even avoid purely rate competition.

The survey collected data on applications for the period 2010 to 2014. Over this period, member grew by 9.2% annually.

"After adjustment to account for factors such as inflation, age, type of diet, bad, pathological profile and limb movement, unexplained expenditure increase per member was still above 2% per annum in real terms.To put this in context, 2% of the expenditure amounted to about R3 billion in 2014, or one R330 beneficiary per year that can not be explained by factors rationally expected to generate expenses, "said Judge Ngcobo

. most of this unexplained increase in the cost of claims could be attributed to hospital care rather than out-of-hospital care.

The survey evaluated the effect of increased use and the possible presence of supplier-induced demand in the private sector, and the survey showed that the demand induced by the supplier was indeed a cost factor. the doctor prescribes only medically necessary treatment. If this relationship deteriorates and the doctor recommends or encourages a patient to consume more care than is required for their medical problem, it is called vendor-induced demand. This happens, for example, if a doctor orders more tests than necessary, practices a caesarean section when it is not absolutely necessary, or admits patients to hospitals when their condition can be treated out of the hospital Ngcobo explains. 19659002] Ngcobo stated that the rates of use were "disturbing".

The survey also found that practitioners had failed to explore multi-disciplinary models of care and that the pay-at-the-time model was only exciting to the public. excess supply and encourage practitioners to provide more services than necessary.

also raised the issue of a globally incomplete regulatory regime in the private health care sector, with medical institutions not being regulated beyond the requirement to hold a license and practitioners licensed to practice by the Health Professions Council of SA. The report said: "This can be attributed to a failure in implementation by regulators and inadequate management by the health department over the years." Motsoaledi defended the government's inability to failing to successfully regulate the sector, saying that its own stakeholders have resisted regulation and that the department has faced threats.

The report may be subject to comments until 7 September of this year and the final report should be published on November 30.