Why the Demarcation Regulations must be scrapped
Government’s second draft of the Regulations that demarcate between Health Insurance Policies and Medical Aid Schemes (the Draft Demarcation Regulations) is in violation of the Constitution and is accordingly unlawful. It is detrimental to the majority of South Africans and discriminatory against the vast number of people who cannot afford medical aid schemes.
This is the crux of The Unlimited’s submission to National Treasury on the proposed amendments to the Demarcation Regulations which closed for submissions at the end of July.
The second draft Demarcation Regulations specify the types of health insurance policies that are permissible under the Short Term and Long Term Insurance Acts. This means that health insurance products that are seen to be doing the job of a medical aid (such as doctor visits, prescribed medication and dentistry) will be outlawed.
This is unconstitutional as South Africans will be denied the right to choose health insurance products that provide access to private primary health care. They will be forced to use the only alternatives available to them: either to pay out of their own pockets or rely on the already overburdened State health care system.
The extent to which the Regulations fail to respond to the 90%* of previously disadvantaged South Africans who cannot afford medical schemes make the Regulations unreasonable and unjustified in a society based on human dignity, equality and freedom of choice. This confirms that by seeking to protect medical aid businesses, the Regulations are ignoring the needs of the majority of the population. Therefore, if passed in their current form, the Demarcation Regulations are unconstitutional as they contravene Section 27 of the Constitution of South Africa, which deals with everyone’s right of 'access' to 'health care services'.
The insurance industry is able to offer day-to-day care at a third of the cost of medical schemes. While premiums vary, health insurance gives families with up to five children access to preventative health care for under R500 per month. When treating minor ailments, they can choose to see a private doctor – making an appointment at a time and place at their convenience. This minimises time away from work and loss of productivity.
Removing peoples’ right to health insurance will thrust more patients into the State health care system – where they could wait for up to six hours to see a doctor followed by another queue to get prescription medication.
The long delays are common due to the many challenges State health care facilities face, such as insufficient funding, poor administration and the burden on overworked doctors and nurses in understaffed facilities. Recent events in the Department of Health in the Free State as well as the fact that the Department of Health in the Eastern Cape is under the curatorship of central Government are two cases that illustrate the gravity of the situation in which State health care finds itself.
When you consider the vast numbers of people who will be impacted by the Regulations and forced to turn to the State for health care, it is clear that the capacity challenges already facing the Government medical facilities will be exacerbated if the Regulations go ahead.
Government has a big job to do, not only in health care, but in education, unemployment and fighting crime too. Meaningful change will not be achieved by Government alone. Health insurance products can create socio-economic transformation and deliver social impacts; but in order for them to do this to do this, Government needs to provide an environment that supports the private sector and ensures continued freedom of choice for its people.
In the case of the second draft Demarcation Regulations, we believe that it is vital that The Unlimited speaks up on behalf of all the people in South Africa who are not aware that their rights are being compromised.
The Unlimited’s submission to National Treasury is available on our website. http://theunlimited.co.za/pressroom/demarcation-regulations-must-scrapped/
