1. Why Primary Care as core benefit in the Basic Package?
Rajesh Patel
BHF
The BHF Southern African Conference July’07 Sun City

2. Health Insurance (catastrophic cover) Health benefit for health need
Current System
Alternate Paradigm
Health Insurance (catastrophic cover)
Health benefit for health need
Commodity
Social Benefit
Focus: Individual
Focus: Community
Benefits
Core: Referred care
Diagnosis based
PMB
Core: Primary care
Benefit category
Traditional design
Competition
Solidarity
Reference price
Regulated price
Allocative inefficiencies
Coherent system for health services provision
The BHF Southern African Conference July’07 Sun City

3. Why Primary Care?
The BHF Southern African Conference July’07 Sun City

4. Hon. Henry Gluckman M.P., M.R.C.S., L.R.C.P.
Community Orientated Primary Care (COPC)
commission mooted National Healthcare System based on COPC
Recognition that HC required rationalization
The BHF Southern African Conference July’07 Sun City

5. Herman A et al. 2002. Tender Doc
The BHF Southern African Conference July’07 Sun City

6. Alma Ata (1978) “Health for All” PHC
The BHF Southern African Conference July’07 Sun City

7. WHO Primary Care … most cost effective… improve health status
(Not every primary care service is cost effective)
The BHF Southern African Conference July’07 Sun City

8. Norms and Standards for District Health (2000)
Starting point towards Equity
PHC based
de facto BBP
The BHF Southern African Conference July’07 Sun City

9. Risk Equalisation: International Review Panel
Include primary care
The BHF Southern African Conference July’07 Sun City

10. NHA Section 3 (1) (d) The Minister must…
…ensure the provision of such essential health services, which must at least include primary health care services, to the population of the Republic as may be prescribed …;
Circular 8 of 2006, CMS
Promote hospital benefit as core benefit
Inconsistent with NHA
The BHF Southern African Conference July’07 Sun City

11. Health Charter In development …Basic Package of health services
The BHF Southern African Conference July’07 Sun City

12. African Union: Conference of Health Ministers 2007
African Health Strategy:
34. This Strategy seeks to advocate and promote a coherent organisational framework that enhances efficiencies and effectiveness through:
“Adopt a primary health care approach” …
“Determining the package of primary health care that all citizens can access”
The BHF Southern African Conference July’07 Sun City

13. Time for Action!
Commence Basic Package development in parallel with Health Charter
Commence the long delayed PMB review as mandated in the MSA
The BHF Southern African Conference July’07 Sun City

14. Speakers Prof. Shan Naidoo Dr. S Pillay
Critical Review of Basic Packages incl. Norms and Standards, and recommendation for BBP : Public Health perspective
Dr. S Pillay
Benefit design for the future
Dr Neil Gower – National Secretary: Homeopathic Association of South Africa
Complementary medicine and the PMB
The BHF Southern African Conference July’07 Sun City