The third edition of Liz Still's Healthcare in South Africa, published by Profile Media, is now available.
Like previous editions the book is aimed at financial advisors, human resources consultants, employee benefits specialists, new medical scheme trustees and others who are obliged to understand the financing of medical schemes, the changing legislative environment and the industry response to these changes.
Still says that a number of important trends are emerging in the healthcare sector.
"In 2006, medical scheme beneficiaries totalled 7.1 million, an estimated 14.8% of the population. In 2001, according to statistics from the Council for Medical Schemes, 15.66% of the population was insured. It is disappointing that the insured percentage of the population has dropped by 0.75% despite a six year period of economic growth.
"On the other hand, Reserve Bank statistics show that more and more people are paying for health care services from their own pockets. November 2007 data shows that approximately R28 billion was spent over and above medical scheme contributions (which were R57.6 billion in 2006) in the private sector. Out of pocket expenditure is often ignored by policy makers.
"To put this in perspective, this was just less than half the National Treasury health budget for 2007, which was R62.7 billion. People are choosing to self-insure, rather than become members of medical schemes.
"There are sharp differences in opinion as to the reasons why people are eschewing medical schemes membership. Some say that regulatory changes, including the introduction of prescribed minimum benefits, ensure the entry level costs of medical schemes are too expensive. Others say that providers of medical care are making too much money.
"Solutions to the problem are varied and include price regulation (an option favoured by the Department of Health), a beefed-up public health service (South Africa spends 3.5% of its GDP, far less than other middle income countries on public healthcare), the increased use of private-public partnerships, the introduction of a range of lower-cost step-down care facilities, and increased price transparency in the private sector," she said.
But according to Still, there are some interesting innovations in the sector.
"Some large companies are beginning to respond to tax incentives which make it viable to introduce basic healthcare either on or off site, outside the medical scheme environment," she said. "It will be very interesting to monitor the progress of these companies in improving the health and absenteeism levels of their staff over the next few years."
Still predicts that the role of managed healthcare providers would become increasingly important over the next few years and that buyers of medical schemes will need tools to not only evaluate medical schemes, but tools to understand the services offered by managed care providers.
The strength of Healthcare in South Africa lies in the design of the book, which introduces readers to the regulatory environment in the healthcare sector, the issues facing the industry and the players in different sectors of the industry. There are a number of interviews with prominent members of the industry who express their concerns and views on the challenges facing the industry.
"Each of those interviewed is given an opportunity to explain the changes to the health financing environment from their point of view," Still says.
The book can be ordered on the Profile Media website www.profile.co.za at a cost R170.00.
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