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Accountability is the cornerstone of sustainable healthcare

28 July 2015 | General

The key goal of the 16th annual Board of Healthcare Funders’ conference is to come up with a roadmap to a sustainable future healthcare system. To this end, the conference is hosting various parallel sessions to debate the key issues and barriers to such a system with a view to coming up with concrete practical proposals that will take us from the system we currently have – fragmented, unsustainable, high-cost, stagnant in terms of medical scheme membership and of variable quality – to one that is sustainable, integrated and, above all, patient centric. This requires accountability throughout the system. “Healthcare is one of the key components of prosperity so an improved healthcare system is imperative to creating a prosperous society and country,” Dr Tebogo Phaleng, Executive Director at Coalesce, an independent health strategy advisory agency, told delegates. “South Africa is currently ineffective in achieving equitable access to health and protecting its citizens from the financial consequences of ill health. This cannot be allowed to continue. If it does, our children will certainly not have access to the healthcare we do at the moment.” The conference discussions mark the fourth phase in the journey towards this road map, further to a pre-conference survey, a gap analysis and a strategic think tank, which identified those areas of the current system that need re-evaluation. “The debates are intended to be collaborative, exploratory and iterative and will take place in a safe space for collaboration.”

Lack of basic health literacy, an obstacle for medical aid users

28 July 2015 | Medical Schemes

Many members of medical aid schemes do not gain the maximum benefits to which they are entitled—mostly because they lack basic health literacy, says Sibongile Mamafha, Principal Executive Officer at Thebemed Medical Scheme.

The quality of healthcare – is it enough?

28 July 2015 | General

Reviewing the findings of the 2015 Health Quality Assessment 2015, Dr Johann van Zyl of Towers Watson’s short answer to the question was ‘no’. This is despite some encouraging trends in certain areas and an increasingly robust data set accumulated over five years, embracing approximately 77% of covered beneficiaries across 18 schemes, nine administrators and 168 health quality indicators. “So much more is still possible,” he told delegates at the 16th annual conference of the Board of Healthcare Funders. “Whether the improvements in quality of care that we have observed translate into true value, given the dramatic increases in both contributions and claims, is also open to debate,” he said.

What is the legal status of CMS circulars?

28 July 2015 | General

CMS circulars are regarded by the regulator as legally binding, but this is not the case. Paul Midlane, General Manager: Legal Governance Risk Compliance, Medscheme, made this point emphatically at the 16th Board of Healthcare Funders conference with detailed reference to the Constitution, the Medical Schemes Act and the Promotion of Administrative Justice Act (PAJA). “All of these legislative measures do not support the legality of the circulars, which often contain unilateral, far-reaching decisions that potentially impact the way we do business in a fundamental way. Neither do they support the CMS’s punitive measures against schemes deemed to be in contravention of the apparent ‘directives’,” he said.

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If you had to hazard a guess, when do you reckon the COFI Bill will be signed into law?

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2026, as promised 2027 looks more likely Impossible to say More consultation needed

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