State-regulated fees on what doctors can charge for their services may leave some considering emigration if the lower tariffs will leave them bankrupt, and this will in turn leave an already overburdened health-care sector even weaker.
“I think we can appreciate the context of what is being said, the threats of people wanting to leave is understandable because what lacks in that bill is context.
“It creates the impression that doctors are not valued and what is the alternative?” The SA Medical Association (Sama) chairperson Mark Sonderup said after reports were rife of private doctors halting their services in South Africa because they say the bill lacks context.
He said doctors reaction to the announcement of this bill was understandable. “When you actually announce plans but provide extremely little context, it’s the lack of detail that provides a lot of uncertainty.”
Last week Health Minister Aaron Motsoaledi unveiled two bills.
He said there would be a mandatory fund for free, high-quality health care.
He also announced the release of the Medical Schemes Amendment Bill which seeks to align the medical aid industry with the NHI.
“Medical doctors are not threatening to leave if the bill gets passed, they are indicating that it will be a direct consequence of the contents of the bill which will leave them with no choice but to emigrate.
“Provinces will remain responsible for maintenance of facilities and with medical liability in the state capped at R1 million, the costs of rendering services in the state will be substantially lower than in the private sector, where maintenance costs and unlimited medical liability applies,” said Dr Johann Serfontein, senior consultant at HealthMan, a division of the SA Private Practitioners Forum.
One of the crucial aspects of the plan will be the mechanism established to determine what fund will pay hospitals, doctors and other medical professionals.
Serfontein said private sector doctors would have to contract with the NHI fund, as medical schemes would only be allowed to pay for services not covered in the NHI.
Dr Henru Kruger chief operations officer of the Alliance of SA Independent Practitioners Association said the bill should be challenged.
“This is a very real risk as medical services are in high demand internationally. We should be very concerned because this is the nationalization of healthcare and when you nationalise healthcare, the private sector will disappear,” Kruger said.
According to the NHI Green Paper, NHI will gradually be implemented in three phases over a 14-year period but the bill does not give an actual date of implementation. The five-year pilot phase on NHI began in April 2012.
The pilots were meant to serve about 10 270 000 people or 20% of the population.
The Treasury has allocated R1 billion for the pilots across 10 districts in the country.