“One of the reasons for the high costs from providers relates to the inability of medical schemes, particularly the smaller schemes to negotiate reasonable tariffs with large provider groups such as the private hospitals,” Health Minister Manto Tshabalala-Msimang said.
Addressing the Health Portfolio Committee in Parliament on Tuesday, the minister voiced concerns regarding escalating premiums paid by scheme members who were getting less in return.
“Medical schemes have been increasing their premiums and decreasing benefit packages so scheme members are now paying more for less benefit,” Tshabalala-Msimang pointed out.
She said the department will be presenting the Medical Scheme Amendment Bill to parliament this year to make trustees and principal officers of schemes more accountable for costs.
“The amendment bill strengthens the governance structures of medical schemes thereby making the trustees and principal officer of the scheme more accountable for administrative costs within a scheme,” she said.
The minister further voiced her concerns with the lack of transparency in costs within the private healthcare sector.
“Last year we introduced regulations relating the development of a reference price list that takes account of the true cost of a particular service, we anticipate that this process will bring greater transparency to private healthcare costs,” she said.
The three cost drivers in the private health sector include private hospital costs, specialist charges and administration charges.
She said due to the department's intervention in the medicine pricing regulations, medical prices, which used to be one of the three costs, had since declined.
The minister also reported on the Commission's investigation over corruption in tenders for the supply of pharmaceutical products, large volume parenterals, irrigation solutions, administration sets and accessories to its public hospitals.
“The Commission's investigation found that the representatives of the companies held telephone discussions and meetings prior to the submission of their respective responses to the invitations to tender.
“In these discussions and meetings they collaborated on their responses and discussed and agreed on prices,” said Tshabalala-Msimang.
The department she said will be reviewing the current tender processes with National Treasury in order to take the necessary measures to discourage collusive pricing practices.
Regarding the guidelines on preventing mother-to-child transmission of HIV (PMTCT), the minister said consultation between the department and experts decided that the PMTCT guidelines should be revised and that dual therapy, using Nevirapine and zidovudine (AZT) should be used.
“After given the complexities of prescribing antiretrovirals especially to children, it has been decided that only registered health professionals, in line with the relevant legislation and regulations, should be allowed to prescribe AZT.
“It should be noted that this has not been an easy decision given lack of unequivocal scientific data and programme evidence on safety and effectiveness,” said the minister.
She added that the programme must be seen as part of the comprehensive approach to the challenges presented by HIV and also critical that the department provides the highest quality of care to both mothers and infants as it implements the revised guidelines.
The implementation of the guidelines require an increase in the 2008/09 budget for PMTCT from R85 million to R281 million, request for additional resources is to be made to National Treasury in a bid for 2008 adjustment, she said.
Article published courtesy of BuaNews
