#NHI will stop medical schemes exploiting members: Motsoaledi

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Johannesburg - Health Minister Aaron Motsoaledi says medical aids in South Africa have been exposed for ripping off members by charging them exorbitant premiums. This comes as Motsoaledi on Thursday vowed that access to healthcare in the country would no longer favour the wealthy - at least not while he was still at the helm. Motsoaledi, who has over the last few months faced a barrage of criticism regarding the country’s overburdened and crippling public healthcare system, is now gunning for medical aids in a bid to shake up the industry. On several occasions, the sector has come under fire for charging high fees to patients. Motsoaledi said the National Health Insurance (NHI) would put a stop to this practice. Speaking at a press briefing in Pretoria, the minister, who has been at the helm since 2009 after succeeding Barbara Hogan, announced that his department was now inviting the public to comment on his proposed Medical Schemes Amendment Act and the NHI Bill, which has been approved by the cabinet.

In his proposed amendments, Motsoaledi called for the phasing out of medical aid co-payments and prescribed minimum benefits as well as "unequal and unfair" benefit options offered by schemes, among other things.

On average, a comprehensive medical aid cover costs middle-income households anything between R1 000 and R4 000 a month.

The World Health Organisation and the Organisation for Economic Co-operation and Development have also revealed that only 10% of South Africans can afford private healthcare.

Motsoaledi said data seen by his department showed that medical aid schemes were holding reserves of close to R60 billion which hadn’t been used, adding that these reserves had been accumulated through the schemes charging high premiums.

He further highlighted that complaints received by the national Department of Health and the Council for Medical Schemes warranted the amendments he wanted to make.

“The amendments mean that every cent charged to the patient must be settled fully by the scheme, and the patient should not be burdened with having to pay,” he said.

He also said the new medical aid system, under the NHI, would do away with brokers, who were paid an amount of R2.2 billion monthly to ensure that people have access to medical aids.

While Motsoaledi was at pains to detail how the NHI will succeed in the face of the turbulence facing state hospitals and clinics, he maintained that the primary objective of the NHI Bill was to ensure that every South African had access to the public and private healthcare sectors of the country without any prejudice.

“We are painfully aware of the fact that some people believe that even before we open our mouth about the NHI, we must sit and fix the ailing public healthcare system first.

“We are very much alive to the problems of poor quality and lack of efficiency in the public healthcare system. That is not a matter of debate. Fixing the quality of public healthcare is an ongoing and continuous process which has no end as long as the health system exists among people,” Motsoaledi said.

He said the current “deep-seated problems” in the private health sector were flagged by the National Development Plan (NDP).

He said the NDP urged all South Africans to deal with problems such as the high cost of private healthcare and the poor quality of care in the public healthcare system.

The Board of Healthcare Funders of Southern Africa (BHF) said it supported the proposed amendments. The BHF represents 45 medical aid schemes in the country.

“As an industry representative body we support the intention and action aimed at ensuring that the greater population of the country receives quality healthcare,” its chairperson Dr Ali Hamdulay said.

He, however, warned the private sector that it was not immune to the proposals made and that it had an equal duty to the people of this country in providing affordable healthcare services.

The SA Communist Party also welcomed the release of the bill, saying it came at a time where there were growing concerns over the affordability of medical aids.

“South Africa must roll back the dominance of medical schemes in healthcare financing through the creation of a single NHI Fund,” the party stated.

The DA member of the health portfolio committee, Lungiswa James, said Motsoaledi’s efforts to spin the NHI plan were fruitless.

“The fact remains that it simply is not feasible. We have already seen how NHI pilot projects across the country failed dismally. Doctors and pharmacy assistants contracted to assist with NHI projects have allegedly not received salaries from the Department of Health’s payroll administrator,” she said.

James said the DA would continue to expose the NHI for what it truly was - unaffordable, impractical and unfair.

Political Bureau