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The cost of healthcare, inadequate benefits and failing public healthcare facilities were very much in the news in 2018 and are likely to continue to feature strongly in headlines in 2019 as South Africa finds its way towards universal health coverage.
Key concerns are the escalating cost of contributions as well as inadequate medical scheme benefits. In combination, these translate into higher out-of-pocket expenditure by beneficiaries. In 2017, it was estimated that beneficiaries had to pay at least R32bn for out-of-pocket medical expenses. This is a significant amount given the challenging economic environment.
Last year indicated a different focus for medical aid schemes as there were several publications relating to reform which will affect the private healthcare space. We witnessed the publication of the National Health Insurance (NHI) Bill and the Medical Schemes Amendment Bill (MSAB), both of which had been long awaited. What the sector found disappointing was that not much was provided to beneficiaries in terms of immediate relief.
The Health Market Inquiry (HMI) published its provisional report, which was very comprehensive, soon after the publication of the two bills. There is, however, a sense of a lost opportunity as the inquiry’s findings were published afterwards and have thus not made their way into the bills. The HMI findings are comprehensive and provide insights based on years of studying of the environment.
The Council for Medical Schemes (CMS) was also in on the action, they published a circular inviting comment on the framework for consolidation of medical schemes. This circular received much criticism and caused significant anxiety among the schemes, particularly those which were specifically mentioned in the circular. It is evident from the circular that more needs to be done prior to consolidation taking place.
The Presidency announced in the latter part of the year that they will be supporting processes to establish the NHI. To this end, several resources from the Presidency were allocated to drive the collaboration. The Presidential Health Summit brought in most stakeholders from the health sector to map a way forward. It looked like a key moment, as all acknowledged and reflected on the poor state of health in the country. There was excitement that there would be a chance for stakeholders to work together for the sake of the much-needed health reform.
The excitement was, however, marred after a leaked document from National Treasury highlighted some potential challenges within the internal stakeholders. The question is whether this will erode the goodwill from the summit and serve to deepen the existing trust deficit.
This year is certainly shaping up to be an even more dramatic year with many changes looming.
The Health Market Inquiry (HMI) was expected to issue its final report in December 2018. When it does come out, the key questions though are whether the recommendations will be in alignment with the other reforms and their activities sequenced to en-able ease of implementation.
The NHI Bill should also come through in early 2019 – probably before elections. In the light of the enthusiasm that surrounded its long-awaited release, we hope it will embrace the input from the various submissions as well as discussions from the consultative meeting and the Presidential Health Summit. The prevailing narrative is that NHI is for the benefit of the citizens, it is so huge a project that there should be more collaboration among all stakeholders across the healthcare spectrum.
While all this is unfolding, we have to be cognisant of the member experience as there are already numerous pressures, mostly economic, that they have been subjected to. With the economy in its current state, other than worrying about job losses, beneficiaries will have to contend with above inflation medical scheme contribution increases. The impact will be worsened by the recently announced interest rate hike by the South African Revenue Service.
Beneficiaries will also be faced with many messages around the future of healthcare, some of which may be confusing as the media will probably be awash with stories and opinion pieces on healthcare and how it should be structured.
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Two business people were burnt to death in a house and their belongings stolen in Northam, Limpopo, on Friday, police have said.
A 24-year old man was arrested in Rustenburg in the North West province for the murder of the two deceased, aged 30 and 33, following a swift response by the police.
All are Ugandan nationals.
Speaking to News24, provincial police spokesperson Colonel Moatshe Ngoepe confirmed that both the deceased and the arrested suspect were all business people: “However, we are still investigating the motive. We have found that petrol [was] used in arson.”
Ngoepe could not immediately explain the nature of the business in which the deceased and the arrested suspect were involved.
He said that on Friday, January 4 2018, police were called to Wildebeeste Laagte Farm outside Northam where they found a house engulfed in flames.
“The police in conjunction with other role players tried to extinguish the blaze but with no success. Further attempts were made to rescue the people inside until they managed to gain entry by breaking the windows as all the doors were locked.
“Subsequently, two people were found lying dead on the floor with serious burn wounds on their bodies,” Ngoepe said.
He said preliminary investigations revealed the identity of the suspect and a manhunt was launched. The trail led the police to Rustenburg where the suspect was arrested.
“During the arrest, the deceased’s motor vehicle was recovered at a chop-shop in Rustenburg and other items which include cellphone, watch and house keys.
“The process of identifying the deceased is under way but they were confirmed to be Ugandan nationals,” Ngoepe said.
The arrested suspect is expected to appear in the Northam Magistrate’s court on Monday, January 7, 2018.
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ANC head of presidency acting national spokesperson Zizi Kodwa has downplayed reports that President Cyril Ramaphosa will meet former president Jacob Zuma to discuss Zuma’s recent public comments.
The ANC held a press conference on Sunday to announce the outcomes of discussions on its elections list process.
Kodwa on Sunday said that a meeting between the two was scheduled, but that it was simply a standard meeting that often takes place between ANC presidents and their predecessors.
The Sunday Times reported that Ramaphosa wants to have a “frank discussion” with Zuma over his public comments which haven’t lined up with the ANC’s official policies.
This includes his recent statements advocating for the nationalisation of land and his denial of state capture, despite the party’s support for the Zondo Commission of Inquiry.
Responding to questions from the media, Kodwa said reports about the meeting between Ramaphosa and Zuma were “mischievous”, as no one was privy to the details of the discussions between them.
Since his election as President, Ramaphosa had met with former presidents Thabo Mbeki and Kgalema Motlanthe, and the Zuma meeting “follows” those meetings, Kodwa said.
He said these meetings were to discuss various issues, but also to “give them tasks”. As they were still members of the ANC, Ramaphosa still gave them tasks to complete for the party, Kodwa said.
The ANC meanwhile finalised its list of around 200 potential names to be sent to Parliament after the 2019 general elections, who will now be subject to further vetting.
The candidates will also be given the opportunity to accept or decline the nomination. The process will be completed by the end of January.
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Cape Town – Proteas skipper Faf du Plessis insists that he and coach Ottis Gibson do not ask ground staff for anything “ridiculous” when preparing pitches for home Test matches.
South Africa beat Pakistan by 9 wickets in the second Test at Newlands on Sunday morning, taking an unassailable 2-0 lead to win their seventh home Test series in a row.
Under the Du Plessis/Gibson era, which began when the West Indian took the reins in August 2017, there has been a spotlight on South African Test wickets.
That conversation reached boiling point in last year’s home series against India when the third Test at the disastrous Wanderers strip very nearly saw the match called off because of its uneven and unpredictable bounce.
After day two at Newlands on Friday, Pakistan coach Mickey Arthur took the issue even further by slamming the pitches in Cape Town and Centurion (the venue for the first Test) by saying that they were not up to Test match standards.
The bounce in Cape Town was uneven at times, but that didn’t stop Du Plessis from carding a century on day two while there were no less than seven other scores of over 50 in the match.
“We never ask for ridiculous pitches. We just ask for pace and bounce,” Du Plessis told media on Sunday morning after the win.
“You have to adapt your game and Temba (Bavuma) was a great example. In two Test matches in a row now on tough pitches he has scored runs and it shows you that it is possible if you apply yourself mentally and you have a technique.”
Bavuma scored a fighting 53 at Centurion while, in Cape Town, his 75 in a 156-run partnership with Du Plessis effectively batted Pakistan out of the series.
Du Plessis does not think that he and Gibson place more emphasis on pitch preparation than any of their predecessors.
“I think maybe we just speak about it more openly than you possibly would have heard about in the past,” he said.
“Our question to any groundsman is always if the pitch has pace and bounce … that’s always what we ask for.
“We don’t ask for anything more than that.
“Everyone expected this wicket to get worse because of the cracks, but it actually got better.”
Du Plessis also opened up on the current state of Test cricket, saying that the fact that matches were moving faster than they were contributing to an increased focus on wickets.
“Cricket is not the same as it used to be a few years ago when there were 400s and 500s being scored all at the time,” he said.
“In South Africa the ball does move and there are seam-friendly pitches.
“The pace of the game has become a lot quicker and batsmen are not just going at 2 or 2.5 an over.
“Test matches are moving so quickly and as a player you have to move with it.”
The series now moves to the Wanderers for the third Test, which gets underway on January 11, and there will no doubt be further discussion about the surface.
“I haven’t seen the pitch (at the Wanderers). The nice thing is that we have a few extra days for the bowlers to have their feet up.
“Once we get to Joburg, we have to see what the pitch looks like. I haven’t seen it since the T20 league where it was dry and had a lot of cracks. It’ll be interesting to see if it’s changed at all.”
