The long-awaited Health Market Inquiry has finally been published. The report represents the single largest and most comprehensive report into the private healthcare industry in South Africa.
The HMI found that the private healthcare market is characterized by high and rising costs in both healthcare and medical aid cover, overutilization and low improvements in health.
This report comes against the backdrop of the publication of the National Health Insurance Bill on 26 July 2019. (Gazette Number 42598)
Findings are divided into Facilities (Hospitals), Practitioners and Funders which are well summarized in the NHI Executive Summary (See link below)
Of particular interest to me is that fact that the National Department of Health failed to make any submission on the preliminary report, but also forged ahead with the NHI Bill. From the findings made in both the preliminary report and the final report, it is clearly evident that the National Department of Health has failed in its obligations to use the tools at its disposal to adequately regulate the Private Healthcare Industry.
These tools include its legislated powers to manage the private healthcare market and failing to hold regulators sufficiently accountable. Hospitals themselves do not fall under any regulatory body besides the National Department of Health itself, and management through issuing of licenses.
A second observation is a focus on the quality of service and clinical outcomes and its lack of relationship to cost. Implicit in the report is that comfort, convenience and convergence of services are paramount in the private sector, while the quality of service in the public sector is most criticized publicly. The costs of both, however, outweigh the health outcomes in both sectors.
Clearly no group has avoided criticism and there are very valuable recommendations made. I do however believe that the publication of the NHI Bill was premature – albeit that it was long-awaited, as the impression is left with this reader that the NDoH will ignore the findings of the HMI and forge forward with NHI as its save all solution to ills in both the private and state healthcare systems.