1. Board of Healthcare Funders
Of Southern Africa
Trends in Private Healthcare Funding as a result of current tariff structures
27th July 2011
Portfolio Committee on Health :Cape Town
Presented by: Dr H. Z. Zokufa and Dr C Mini
Chairman and Managing Director of BHF

2. Contributions Investors Investors Providers of Healthcare
Private Healthcare
Funding
2009/10
99 Medical Schemes
8.2 Million members
R84.8billion
R76.3 billion payment
R2.5billion deficit
Providers of Healthcare
Private Hospitals
Medical Specialist
General Practitioner
Pharmacists
Nurses
Physiotherapists
Allied Health
Traditional Healers
Healthcare Products
Pharmaceuticals
Medical devices
Surgicals
Medical Equipment
SA Constitution
Government Healthcare Policies
Legislation
Medicine and Related Subst Act
National Health Act
Medical Schemes Act
Pharmacy Act
Nursing Act
Health Professions Act
Traditional Health Pract. Act
Competition Act
Consumer Affairs Act

3. Health benefits paid in 2009

4. Trend in Healthcare costs

5. Contribution rate changes

6. Trend in number of beneficiaries

7. GAPS IN THE S.A. HEALTHCARE SYSTEM
No robust quality assurance and assessments systems linked to cost
No robust health technology assessment
No meaningful peer review processes
Inadequate regulatory controls to protect the consumer
No perfect market in healthcare
Behaviour of entrepreneurs
QUESTIONS
Can sector take care of itself?
Is the consumer adequately protected?
Is the sector having the interest of SA citizens at heart?
Are the models, systems and processes in place appropriate?
Who can intervene ?

8. Concluding Remarks and Proposals
There is a gap in the system – fully exploited.
There is unacceptable fragmentation.
The ordinary consumer is vulnerable.
Modelling of healthcare as an ordinary commodity.
Applying brutal business principles to healthcare as an ordinary commodity.
Getting sick - ? tipping point for poverty.
The Minister of Health must intervene – Section 27 of the Constitution
Legislative framework for healthcare prices control.
Reversal of Competition Commission ruling of 2003.
All the spheres and arms of Government must support this.
Introduction of National Health Insurance (NHI).
Healthcare Quality measurements.