True devotion to health care

Expanding health care access in South Africa demands meticulous resource allocation.

This is crucial for delivering the calibre of service essential to upholding the human dignity of our entire population.

Defining what constitutes value in health care cannot be separated from the quality of life of the person on the receiving end, the standard of health care they receive and whether the patient’s suffering is eased and their daily functioning restored without unnecessary delay.

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At this pivotal moment in South African health care, it is essential that the quality and quantity of health care services are defined and configured in a sustainable balance to ensure our world-class health care skills and assets – which are largely privately funded – are retained, nurtured and grown to accommodate the country’s wider health care needs.

Access for the masses

The regulatory framework, if reformed as recommended by the Health Market Inquiry which started a decade ago, could create more practical and sustainable improvements to universal health care coverage for South Africans and provide more affordable health care for medical scheme members and greater access to those without cover.

This will avoid the growing number of individuals who cannot afford health care cover and are placing additional pressure on overburdened public health facilities.

Medical scheme members contribute substantially to the public health system as taxpayers and make very little use of state services, thereby freeing up resources for those who depend on public health services.

Despite the predominantly negative attention directed at the National Health Insurance (NHI), it’s imperative to acknowledge its potential for significantly improving accessibility to quality health care.

While criticisms abound, it’s crucial to recognise the positive impact it could have in extending affordable, high-quality private health care to millions more South Africans if appropriately implemented.

There is full agreement that quality health care should be extended to all South Africans and we see great potential for medical schemes as a collective to assist in elevating the standards of health care afforded to all employed South Africans and their families.

At best, it will take decades until South Africa’s future health system is capacitated to replace the services currently provided by medical schemes in their entirety.

We see this as an opportunity to work together to build quality health care overall. With the outstanding regulatory gaps addressed, we could create health cover solutions for the many employed South Africans for whom medical aid is unaffordable at present.

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Comparatively well-off enough not to rely on the state, this missing middle could be accommodated through private health funding employment benefits, at least until the NHI system is geared to provide adequate care for all.

Finalisation of the low-cost benefit options framework and regular reviews of prescribed minimum benefits to complete health funding regulations would considerably reduce costs while maximising relevance.

Making medical scheme membership more affordable through rational regulatory means will help keep many employed people healthy, actively contributing to the economy, and keeping them out of hospital by providing meaningful access to health care for a larger proportion of the population.

People should choose where they go

An important point here is that tax incentives in the private sector which are currently targeted and have in real terms been reduced, may be more effectively spent by individuals accessing health care where they choose, rather than dictating where and how they access health care, as envisaged in the NHI Bill.

In the end, consumers often know where they get the best bang for their health care buck. Until the NHI system is fully equipped to provide a level of care approaching this for everyone, private health funding is ready to help shoulder this responsibility to realise the goals of universal health coverage.

The practical truth may be that the NHI will remain limited to what the country can afford, but this need not define the entire extent of health care services that individuals will continue to require.

We strongly appeal to the president and policymakers not to disregard the spectrum of opportunities for making progress towards universal health coverage with prudent revisions of the existing regulatory framework.

• Comrie is chair of the Health Funders Association, a professional body representing medical schemes and their members