I was interested to see in the press recently that the Competition Commission is launching an inquiry into the costs of private health care.
Economic Development Minister Ebrahim Patel’s announcement came as no surprise, but some in the private healthcare sector may be less enamoured of the fact that they will be the guinea pigs for the Commission’s wide ranging new powers.
The new powers allow a much more in depth inquiry than before, when only specific instances of collusion and price fixing could be investigated. The inquiry will take up to two years to complete.
Rather than starting the discussion by giving you my opinions, for a change I have decided to canvas yours first!
- Do you think this inquiry is necessary?
- Do you think this is a witch hunt?
- What do you think the outcome of this inquiry will be?
- What is your view of this inquiry?
- Do you think it will help us understand why the private healthcare sector is becoming unaffordable?
Over to you!
Len Deacon 
I do think the enquiry is needed, BUT the focus need not only to be on Hospitals but the bigger picture…. All providers should be taken in to consideration as some of the suppliers relating to an admission is what is making it so expensive… The fact that NHRPL is not imposed and regulated with an iron fist anymore makes the industry ready to collapse with regards to private healthcare costs
Antoinette your comment is right on the money. Sadly the largest escalation and cost in many Health funds now is the area of Hospitalisation. To me the area that needs to be considered is if all hospitalisation is appropriate and the most medical and cost effective way to treat the condition. It would really add much value if a longitudinal study of the changes in Hospital treatment for the past 20 years could be undertaken. This would help us to see the changes and what more cost effective treatment methods of the past have been replaced by hospitalisation.
I agree with your comment…
I’m also of the oppinion that doctors are uneducated with regards to clinical validation, PMB rules and Scheme rules…
Doctors see an authorizaton number as a blank cheque and they advocate it to their patients… Thus patients perceive short payments as over charging…
Doctors are used to just treating and not taking in to considiration the financial outcome too – thus the implimentation if the consumor protection act… That the doctors are still not adhering to.
Treatment sometimes are just broad and the use of ou “big shot” antibiotics are increasing our resistant super bugs in hospitals… Just due to the fact that they do not want to take advise from our fellow collegues, nurses, pharmacists or micro biologists…
I think a service level agreement should be signed by doctors and funders… And their oath should be re discussed with them annually.
Antoinette some real great insights and ideas. Do you think it is achievable to implement some of your ideas and if not why?
Yes I do think that my ideas are very simple and doable projects and achievable with the right influance and attitude. People in the healthcare industry tend to only look at the patient’s physical and emotional wellbeing but tend to forget the financial wellbeing and the health imolications this have on any patient…
Private healthcare is a business and NOT a passion anymore (fir a few it is still a calling)
Antoinette your comments may be true for some doctors but i would think that like most people in business they want to make the best return. Excessive returns for any healthcare provider being Hospitals, Doctors or device suppliers etc result in healthcare becoming unaffordable and beyond the reach of the middle class. What we need is a re-look at how we charge for healthcare. I believe a cost based review is required where we match the actual cost to the service delivered and not what healthcare suppliers believe the patient can afford. I have heard of horror stories of the profit being made on devices and some healthcare services.
Healthcare is a social good and not a commercial retail product. So some kind of administered pricing is required to keep healthcare costs down to a level that all citizens especially those who are in employment can afford healthcare cover. Those unemployed must remain the responsibility of Government/State. However the quality of the service they receive in State/Public facilities must be of a high and acceptable clinical quality. The six areas that that our Minister of health is focusing on will help to correct the existing problems. I firmly believe the private sector has a positive role to help the State to improve both the private and Public sectors.
Yes, questions need to be asked. Life is too complicated. All we need is transparency and efficiency. People need efficient evidence based care to get better. People need to be given transparent information about their Health & Treatment. We also need to ask why we cannot make healthcare cheaper. Dr Devi Chetty (Heart Surgeon in India) is working on making healthcare cheaper. All we need is a healthcare system that works and is not out of reach (Private or Public).
Mogale, you have touched on area I am very passionate about. I believe as Albert Einstein said ” We cant solve the problems we face using the same mind set” I worry that when we look at the cost escalation in healthcare we have the same mind set and thinking that created the problem we are in. I agree with you we need a truly transparent cost based healthcare system where reasonable profit is made and people don’t get rich over night or make excessive returns. Health is a social good and not a commercial good. Also we need coordination of care that is rational and cost effective. This means that the GP should once again become this coordinator of care and all care should be coordination via them. This way we will start making sure duplicate test and care is reduced and one care provider has the big picture all the time.
I agree completely that there must be better regulations… And yes they are runnung a business but the very fine line between business and ethics are being questioned in my mind… I’m also of the opinion that we are here today in this crisis because the regulations where taken away… People need to up their healthcare education and empower them self too. Co-ordinated care is a good solution too. The consumer protection act states that you should be informed and it is your patient right to know what the charging rates or tariffs are. But yet, patients still dont ask or prepare before admission. Thus, no one is complaining at the HPCSA because they dont know their rights.