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Thanks Edman, The medical aid rate for a consultation is between R180-R200 - specialists are reimbursed about R2 more than a GP. Seeing that a consultation is usually between 20-30 minutes, the hourly rate would work out at about R600 Do you feel that is fair reimbursement

Henri, If I may ask you what do you think a surgeon in private practice earn and then what do you think he is worth knowing the following: - studied 6 years to get medical degree - do internship for another year - 2 years of medical officer - 5 years of being a registrar to become a surgeon with a M degree - start at work at 06:30 and then get home at 8 every night - do 2 calls a week of being 24 hours available for Casualties - do 2 weekends a month of being 24 hours available - only start earning money at 31 - that means an average of 8-10 years after your peers - knowing that one mistake can kill somebody or get you reported at council Regards

CJVDM, The reason why we don't always charge the NHRPL price, is that he tariff has not kept up with inflation and medical costs - studies performed by the various professional societies within the medical community have proven that the NHRPL price should be closer to 300% of what it is now - it is just very convenient for the medical aids to pay the list price. Why do you think that certain medical aids are prepared to pay 2-3 times the list price if it was so unreasonable. Another thing you should remember is that the cost of living in certain cities are much higher than others - a surgeon in Bloemfontein can live a comfortable life charging the list price but once you live in the Northern Suburbs of Johannesburg that does not hold true. You say that if you dont get quoted the best price, you may not choose a certain individual - remember that you are not dealing with motor spares here - there are reasons why certain doctors feel that their services are worth more than a list price - if you need specialized care and you want it done by somebody who knows what he is doing, you are going to pay for his expertise and experience - if you are prepared to go to somebody who will do it cheaper, that is a risk you'll need to take.

Henri, Did the consultation include an ultrasound and a PAP smear - the ultrasound alone would probably account for about 400 of the consultation of which a part will go for repayment of the ultrasound machine. If you pay R4000 a month for your medical aid, I presume you have a savings account - therefore you can submit your account of R900 to the medical aid and you will be reimbursed the full amount if your savings has not run out. Why should the medical industry be any different from any other industry - you would not go to Woolworths to buy groceries and then tell them to get paid by a 3rd party. The only time that this complaints about fees will stop is when the so called medical aid rate is scrapped and it becomes a market where you get a quote, the service is delivered and the money is paid by the patient to the doctor and the patient claims back from his medical aid.

Dear all replying on this post, I am a specialist in private practice and I dont charge medical aid rates unless discussed with me beforehand by the patient and even then I will not charge medical aid rates except if the patient is a pensioner or I know the patient cannot afford higher rates - I do try however to charge what the medical aid pays out [Discovery 200% for example] The medical aid rate for an appendectomy is R1243 - take of VAT and it leaves you with R1068 - take from that 40% for tax and it leaves you with R640. Do you think that is a fair rate to get your appendix taken out - just to get an electrician or plumber to come to your house will cost you R500 and that is without any services delivered. With the increases in doctors being sued and taken to Council, it is clear why we have a shortage of doctors in this country - it is just not worth the effort anymore to deliver a service at medical aid rates. Why did you not discuss the rates before you went for surgery - doctors are good enough to come out at 2 in the morning to help you out and get you back into action with usually minimal complications but when it comes to paying the bill, there is always an issue. In the Northern Suburbs of Johannesburg you will struggle to find any specialist not charging 3 times medical aid rates and this is the rate that has been set as acceptable by most of the professional societies. It is time that patients realize that a medical aid is like an insurance cover - it is not a guarantee of full payment and there will usually be a top up. Luckily for those who dont want to accept this type of charging there is always the NHI coming. Regards

Jaco-fiets, Even if the environment around a burns patient is sterile, a burn wound become colonized by the patients own bacteria within hours - once you have lost your protective barrier, infection soon follows. Unfortunately the media was out to sell papers again by telling half the story and true to form most people responded after hearing only half the story. If you think logically about the whole story you need to ask the question which sober doctor will amputate normal legs in a child and which parent will sign consent for such a procedure

Does anybody have any facts of what really happened - it sounds like a major screw up but I think judgment should be reserved until the facts are known

I would consider the new LOOK frames with Chorus [i dont think you gain much by paying the extra money for Record] or SRAM Red - add to that ZIPP 404 and you have a great racing machine. Unfortunately 70k wont get you the top end when buying frame, wheels and group set. Good luck and enjoy your shopping

I am sorry if my post came over as too sarcastic but I actually did ask a question of how this was anti-competitive and the reply I got was sarcastic. I appreciate your explanation put down in your post, but were these increases fixed and no bargaining on the price allowed and what would the penalty be to a cycle shop who decided to give discount.

Jules, seeing that you are so well versed in all aspects of life and seem to be a specialist on every field, I beg you my master, teach me Humbly yours

I have read the letter posted on the forum and now you have to excuse my ignorance as I have no background or training with regards to legal aspects. Why is it wrong for an industry, when not coping with profit margins to decide that they need bigger margins - as long as the cycling shop have the right to discount on the prices set and as long as discussion of prices are allowed between the customer and the shop, I dont see the problem. [and again understand, this is coming from somebody not knowing the law] If this is unlawful, surely the whole medical industry is anti-competitive as there is a board of healthcare funders who unilaterally decide once a year what they are prepared to pay and what the increase in the medical aid rate will be. What will be illegal according to me, is if there is a set price for example for a Campag Record Chain and cycling shops get penalized if they offer discount to a customer.

Yes Mamparra - my 22nd post gave me a lot of pleasure, but I think my 23rd will give me greater pleasure - what does that have anything to do with the topic - does my opinion count less than somebody with 11000 posts. So one of the people of the "form" was there - it does not change my opinion that most of the posts about this topic are made by people who has no idea what's really going on in the industry.

I feel so privileged to belong to a forum of such well informed individuals - not only are they specialists in their field, but in their free time they have studied in the intricacies of the cycling industry. They know exactly what the cost price of a certain item is, as well as the mark up on the item. They also know what the running cost of a cycling shop is and the breakdown of income between income from servicing of bikes and the selling of new bikes. They also have the ability to know what was said on a meeting without actually being on the meeting. I feel truly blessed.

Speak to Marco Swart at Cycletech in Kyalami - he is the agent for the SRAM road groupsets in SA - he was at the Argus Expo and you probably spoke to him or Ettienne. Number is: 0114669974