The Government’s Green Paper on National Health Insurance is signalling a new era in public healthcare, and it is essential that private medical schemes remain viable well into the future.
This is the opinion of Blum Khan, CEO of Metropolitan Health, South Africa’s largest medical scheme administrator, who added his voice to the recent overwhelming support from the private health insurance industry.
While acknowledging that it may be necessary for further rationalisation within the medical schemes segment to continue in order for a less fragmented system of larger, more efficient risk pools to emerge, Khan is pleased to see the high priority the Minister of Health and the Green paper has placed on addressing pricing in the private sector.
“Even when a fully functional NHI system is in place, a well-regulated medical schemes and health insurance market is likely to remain – the size of such market being largely determined by demand from healthcare consumers and employers,” he said. “We are pleased to note that freedom of choice underpins the approach outlined in the Green paper.”
Khan welcomed the “realistic and pragmatic approach” of Government which recognised that both public and private healthcare in its current form is unsustainable.
“This removes the blame apportionment and destructive conversations that have dominated the healthcare industry over the last ten years,” he said.
He was heartened by the clear policy direction for healthcare in South Africa, which is crucial for growth, “particularly at this time, with volatility and uncertainty across global financial markets at an all-time high”.
Khan pointed out three critical factors which will determine the healthcare landscape that will emerge with the introduction of NHI.
· The nature and level of benefits covered in the NHI benefit package. The level of benefits and the costs attached to the package will determine the extent to which healthcare consumers will want to “top-up.”
· The range and numbers of private providers that are accredited to provide services funded by NHI. If large sections of the private sector remain unaccredited, those consumers wishing to access healthcare delivered by non-NHI providers may wish to fund this through a medical scheme.
· The extent to which the public sector is upgraded and able to deliver a significantly improved healthcare service. If public sector service delivery is greatly improved, perceptions are likely to change over time and health consumers will be more open to using the public sector.
For Khan, one of the most positive aspects of the Green Paper was its practical approach.
“It is clear that the approach is to be think big, start small, maintain momentum and continuous progress through a process of incremental improvement,” he said. “This is an approach which we identify with as a business and which we believe is practical, realistic and will deliver sustainable success in the long-term. The time-period of 14 years for reforming South African healthcare is certainly more realistic than some of the initial estimates and this bodes well for a successful outcome.”
“While the road ahead is long and no doubt bumpy, the release of the Green Paper provides a broad road map of the path we all need to travel as a country,” Khan said. “I for one am looking forward to the journey.”