Health care in the spotlight

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Published Mar 12, 2016

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Cape Town - Private hospitals were on Friday depicted as profit-driven hotels for patients who were often sent to public hospitals once their funds ran out.

This formed part of the national health department’s presentation during the Competition Commission’s ongoing inquiry into the reasons for rising costs in the private health sector.

The public hearings continued this week at the Cape Town International Convention Centre.

Yesterday Health Minister Aaron Motsoaledi told the commission about his run-ins with the private health sector and how he preferred to use public health services.

Motsoaledi said he spent R14 000 a month for his medical aid plan, but by last October his funds had already run out.

He also recalled how he once needed an ambulance to take his son to a private hospital, but was told he needed to pay an extra R5 000 in cash for that service.

“And the person on the phone told me they didn’t believe that I could pay the R5 000.”

The impression, Motsoaledi said, was the private sector came to the rescue of the public sector, but this was not necessarily so.

“Private hospitals charge so much that patient plans can’t even afford it. Patients are then transferred to public hospitals.”

Meanwhile, private hospitals could pay professionals high fees and employed 80 percent of the country’s specialists for 16 percent of the population. This left the public health sector with far fewer specialists for more patients.

Motsoaledi said the fundamental problem was the private and public health sectors had “completely different” ideas about health care.

“Our definition of health is completely different to theirs,” he said.

“I’ve been accused many times of fighting the private health sector. It’s been said the NHI (government’s national health insurance plan) is meant to kill the private health sector. It’s not our intention.”

Anban Pillay, the Health Department’s deputy director-general for health regulations and sector-wide procurement, used statistics to show how the private health sector was allegedly ripping off patients.

He said private hospitals were the biggest culprits, having pushed up costs to prioritise profit instead of patients.

Pillay pointed to a number of private hospitals that are publicly listed companies on the Johannesburg Stock Exchange.

“I don’t want to suggest that listing on the stock exchange is a bad thing,” he said.

“But investor expectation needs to be managed when we look at health care. The primary objective should be the patient.”

Pillay also pointed to price differences in the private and public sectors for the same medical procedures.

Medical male circumcision, for example, would cost R1 121 when performed by a general doctor. In the private health sector the same procedure cost R7 130.

He showed many cases in which the cost of surgery in South African private hospitals was higher than numerous developed countries and second only to the US in cost for patients.

Relying on statistics from 2010, Pillay showed the private health sector spent R84.7 billion that year. Of that, R30.8bn went to private hospitals and R1.5bn to brokers.

Motsoaledi said brokers needed to be cut out completely to save consumers cash. He said their fees had increased 800 percent from 2000 to 2005.

The commission’s hearing forms part of a three-year investigation into the rising costs of private health care in South Africa. The next round of hearings is scheduled for Pretoria from March 29 to 31.

The commission is expected to release its recommendations to address the costs of private health care at the end of the year.

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