NCR - Healthcare will die in SA ,with new plan

[Konaman]

 

First they ruined the school system, then the police and their capacity to reduce crime, then service delivery in state departments, then the courts are friendly with criminals, the roads are falling apart, no other western country recognize the qualifications obtained by our university students,  etc etc etc

Where is it going to end?

Now private Healthcare will be next to mess up, because its to good for African standards. Check this out to see how it will affect you.

Just dont crash with your bike because, Pretoria will have to authorise your admission at a State hospital, that will probably have no bandages or doctors to look after you.

http://www.health24.com/news/Health_care/1-918,51272.asp

Taken from the News24 website.

NHI: key details

Last updated: Wednesday, June 10, 2009

Print

 

In

his State of the Nation address, President Jacob Zuma announced the

introduction of a National Health Insurance system. We're in possession

of the confidential document in which an ANC task team sets out its NHI

plan. Here are the details of the NHI plan. By Mari Hudson, for What?s New DOC

 

NHI plan in a nutshell

 

 

 

1. Every employed South African will have to contribute to NHI.  - 5% of your salary I believe

2. Members can choose a primary health care provider from a list of

   accredited providers in the private and public sector in their district.

Members will be allowed about three visits to their chosen

clinic/GP per year. Visits to higher health care facilities and

providers will have to be authorized, possibly from NHI headquarters in

Pretoria. Otherwise members will have to foot the bill themselves.

Private health care providers contracted by the NHIA will earn much less per patient than the medical scheme scale of benefits.

Salaries, working conditions and management skills need to be

improved. Expat health and managerial professionals must be attracted

back to South Africa.

The Cuban doctors programme will be revived.

The state plans to manufacture its own drugs.

 

 

How the ANC wants the NHI to work:

 

 

On funding and access

 

 

 

• The ANC?s NHI task team proposes that a

  ?yet-to-be-established? body called the NHI Authority (NHIA) will pool

  all funds from general taxes, a new mandatory pay roll levy and medical

  scheme contributions from GEMS and other public sector medical schemes,

  into a new government-controlled NHI Fund. This will be used to

  purchase health care services from the public and private sector.

The employers? and employees? mandatory NHI contribution could

initially be at a lower level than their current medical scheme

contribution, but will gradually increase to the level of contributions

currently paid by medical scheme members.

The NHI fund ?will promote social solidarity through income and risk cross subsidisation.?

All South Africans will have equal access to equal health services

? but these services should preferably be public sector clinics and

hospitals, including those (more than 50%, according to an official

audit) that do not meet the minimum accreditation standards.

 

On the new structure

 

 

 

• The NHIA will receive funds from various sources, then pool

  these resources and purchase services on behalf of the entire

  population.

The NHIA will be run by a CEO who reports directly to the minister

of health, and will be supported by an executive management team and

specific technical committees (including a technical advisory,

auditing, pricing, remuneration and benefits advisory committee).

The NHIA will be publicly administrated, will be ?a public entity?, and ?there will be no role for private intermediaries?.

The NHIA will have subnational offices at provincial and district

levels. The district health councils and provincial sub-authorities

will plan for infrastructure and service provision. The NHIA will then

purchase these services on behalf of the districts.

?Significant improvement in managerial capacity? at district level will be key to the success of the NHI.

 

On service providers

 

 

 

• The first choice in primary health care provision will be

  accredited community health centres and private GPs. Secondary,

  tertiary and quaternary levels of care will be provided mainly by

  public hospitals, but also by private specialists and private hospitals.

The ultimate objective is to secure provider payment for all

accredited providers; risk-adjusted per capita payments for GPs,

community health centres, clinics and others; and case-based payments

for hospitals, salaried doctors and specialists.

?Given the current capacity constraints in the public sector and

the need to reduce the disruption of services, budgets will continue to

be used for both primary care and hospital level providers in the

public sector, until such time as a facility is accredited,? according

to the plan.

Out-of-pocket payments will only be made in exceptional circumstance.

There may be an element of better payments for increased performance.

 

On registration for NHI

 

 

 

• Every South African will be registered for the NHI and assigned to specific health care facilities closest to them.

Everyone will receive a NHI card to show when they visited their assigned local primary health care clinic or GP.

All patient information will be on electronic patient records so that health authorities can plan according to need.

 

On the benefit package

 

 

 

• The benefit package is comprehensive, operating with the current public health services as its benchmark.

Members will choose a primary health care provider from the list of

accredited providers in the private and public sector in their

district. They will be encouraged to use public sector facilities.

Members will be allowed about three visits to his/her chosen clinic/GP per year.

Members travelling outside their district, might be allowed to

visit a facility, but this will be discouraged and only a limited

number of visits outside the district will be permitted.

A member?s benefit package will comprise ?comprehensive out-patient

and in-patient care at public and private health facilities?, but it

will be capped, and only authorised (possibly only by the NHIA in

Pretoria) referrals to secondary, tertiary and quaternary levels of

care will be allowed.

If a member visits any specialist or private hospital without

authorised referral, he will pay out of his own pocket for the

treatment.

 

On auditing and accreditation of facilities

 

 

 

• The NHI plan proposes that a detailed audit of all public

  and private facilities in the country be conducted in order to

  establish the stock and distribution of these facilities.

?The credibility of the NHI will rest on the visible improvement

in the provision of quality of services for all. All facilities,

private and public, will be NHI accredited, based on agreed national

norms and standards. The aim is to accredit at least 25% of facilities

annually, over a five year phased period, until all facilities are

included,? the document states.

But all public sector clinics and hospitals will be contracted by

the NHI, even if they deliver services below the accreditation

standards.

 

On human resources

 

 

 

• ?Comprehensive strategies for increasing the supply,

  quality, distribution, and retention of various categories of health

  workers in the country? should be implemented, the plan states. The

  funds will be used to fill vacant posts (more than 30% of doctors?

  posts and between 36%-56% of current nursing posts are vacant), to

  create new posts (South Africa immediately needs more than 70 000 more

  health professionals, according to the Roadmap document) and to create

  new posts as nurses? training colleges are re-opened.

Working conditions and salaries are to be improved in order to

attract South African health and managerial professionals in other

countries back to a ?more efficient public health care sector?.

The Cuban doctors programme is to be revived. A new and large

contingent of Cuban doctors is to be imported to fill vacant posts and

so allow foreign nationals to practice legally.

Although the plan mentions occupation pecific dispensation for

public service doctors, and President Zuma said the government was

paying ?urgent attention to the issues of remuneration of health

professionals? to remove uncertainty in our health services, there is

no mention of budget allocations for a 50% increase.

Private health care providers contracted by the NHIA will earn much

less per patient than the medical scheme scale of benefits and these

practitioners are expected to adhere to the NHIA?s prescribed treatment

protocols.

 

On the shortage of drugs

 

 

 

• ?There is also a need to implement the Polokwane Resolution

  to establish a state company to produce drugs as a means of reducing

  the cost of medicines,? the plan states.

 

[mudda]

?Suppose that every day, ten men go out for beer and the bill for
all ten comes to $100. If they paid their bill the way we pay our
taxes, it would go something like this:

The first four men (the poorest) would pay nothing.

The fifth would pay $1.

The sixth would pay $3.

The seventh would pay $7.

The eighth would pay $12.

The ninth would pay $18.

The tenth man (the richest) would pay $59.

So, that?s what they decided to do.

The ten men drank in the bar every day and seemed quite happy with
the arrangement, until on day, the owner threw them a curve. ?Since you
are all such good customers,? he said, ?I?m going to reduce the cost of
your daily bee r by $20.? Drinks for the ten now cost just $80.

The group still wanted to pay their bill the way we pay our taxes so
the first four men were unaffected. They would still drink for free.
But what about the other six men ? the paying customers? How could they
divide the $20 windfall so that everyone would get his ?fair share??

They realized that $20 divided by six is $3.33. But if they subtracted
that from everybody?s share, then the fifth man and the sixth man would
each end up being paid to drink his beer.

So, the bar owner suggested that it would be fair to reduce each man?s
bill by roughly the same percent, and he proceeded to work out the
amounts each should pay.

And so:

The fifth man, like the first four, now paid nothing (100% savings).

The sixth now paid $2 instead of $3 (33%savings).

The seventh now pay $5 instead of $7 (28%savings).

The eighth now paid $9 instead of $12 (25% savings).

The n inth now paid $14 instead of $18 (22% savings).

The tenth now paid $49 instead of $59 (16% savings).

Each of the six was better off than before. And the first four
continued to drink for free. But once outside the restaurant, the men
began to compare their savings.

?I only got a dollar out of the $20,?declared the sixth man. He pointed to the tenth man,? but he got $10!?

?Yeah, that?s right,? exclaimed the fifth man. ?I only saved a dollar, too. It?s unfair that he got TEN times more than I!?

?That?s true!!? shouted the seventh man. ?Why should he get $10 back when I got only two? The wealthy get all the breaks!?

?Wait a minute,? yelled the first four men in unison. ?We didn?t get anything at all. The system exploits the poor!?

The nine men surrounded the tenth and beat him up.

The next night the tenth man didn?t show up for drinks, so the nine
sat down and had beers without him. B ut when it came time to pay the
bill, they discovered something important. They didn?t have enough
money between all of them for even half of the bill!

[Hog_]

• The benefit package is comprehensive, operating with the current public health services as its benchmark

 

Now this scares me! I was inside a public hospital twice in the last 10 years, both times to help remove injured friends and take them to a private clinic.

 

 

 

 

 

[aleksandar]

 

• The benefit package is comprehensive' date=' operating with the current public health services as its benchmark

[/quote']

 

Now this scares me! I was inside a public hospital twice in the last 10 years, both times to help remove injured friends and take them to a private clinic.

 

 

 

 

 

Wife works in better public hospital but still I would not go there.

Scary!!

 

[Goodbadugly]

Just like grade 1 school kids thinking they can buy a Merc with R200. It took the UK (First world country with money) about 10 years to implement their system. Our government(third world country with less money and in a recession) promised their voters a NHI in 2011... I wonder where they plan to get the hundred billion rand (excluding bribes) to get this system up and running. Also from the 5% of the population paying tax?

[no.one.knows]

The bigger picture is that in doing this, the government fat cats get more money. Its that simple!!!!

[Tumbleweed]

The benefit package is comprehensive' date=' operating with the current public health services as its benchmark[/quote']

Now this scares me! I was inside a public hospital twice in the last 10 years, both times to help remove injured friends and take them to a private clinic.

spent the night after my recent accident in a state hospital. they x-rayed nearly every part of me. the aging eastern euopean doctor who examined me declared i had a broken nose and sent me home hours later. a day later, after much discomfort, i went to the private hospital near my home?and then the list of injuries got longer and longer as the doctor picked up the stuff the first one missed.

[pastapouch]

Just like grade 1 school kids thinking they can buy a Merc with R200. It took the UK (First world country with money) about 10 years to implement their system. Our government(third world country with less money and in a recession) promised their voters a NHI in 2011... I wonder where they plan to get the hundred billion rand (excluding bribes) to get this system up and running. Also from the 5% of the population paying tax?

 

from that horrible colonialists , better known as the white man , who work and do not strike for every little reason.

[sias]

Hulle wil die privaat mediese dienste ook opv.k want dis nog al wat werk in die mediese w?reld in SA omdat wittes in beheer is. Alles wat hulle hulle hande op l? word totaal opgev.k.

Hulle wil nou die universiteite ook "transformeer", veral die wit Afrikaanse universiteite wat nog standaarde het en nog inrternasionaal erken word. Volgens hulle is dit nie aanvaarbaar nie en moet die standaarde verlaag word deur transformasie - maw dit moet ook totaal opgev.k word...

[Konaman]

I some times think its an inferiority complex that causes all these problems.

For this system to work, you need very good state healthcare institutions because they will make up the bulk of the suppliers and the first line of treatment.

People will probably have to go to their facilities first, sit and wait for 3hrs plus to be served, then if they cant help you, get authority from Pretoria to see another doctor ,and then you must hope and pray that the  have "the best of 1950's" antibiotics in stock, or you will get nothing. This is going to be life!! Have a nice break from work when you are feeling ill and "hub" on your fancy cellphone while waiting for service. Hehehehe

 

[AndreZA]

A bit off the subject but kinda still on health and safety.

 

 

 

I heard this morning that a lady in Ruimsig received a bill from the fire department for being called out when her house burned down over the weekend. They did arrive 2 hours too because they were on strike but still demand to be payed.

[daggavis]

less than 4 million taxpayers can't support the masses of 40 million plus anymore..The middle class will eventually dissapear and become poorer as we have to foot the bill for everything..50 years from now i'll probably be dead, but SA will be like every other african country..

 

Yes you!, who are reading this post is footing the bill for than f*cking ML Merc that was stolen from that MP, that wasn't insured!

[porky]

less than 4 million taxpayers can't support the masses of 40 million plus anymore..The middle class will eventually dissapear and become poorer as we have to foot the bill for everything..50 years from now i'll probably be dead' date=' but SA will be like every other african country..

 

[/quote']

Unfortunately you are right. We will have a seriously top heavy situation where those who are working and contributing, will be covering medical expenses of those who are not employed, and with our very high unemployment rate, this is obviously not sustainable.

 

Plus, those who do work and could be considered say Middle class and upwards may still be forced to pay for private medical funding simply because they dont want to go to a public or state facility for whatever reason.

 

I think the idea is noble and desperately needed, however it sounds like its just a public friendly proposal at present, makes everyone feel warm and cozy that the government is doing something for you, if or when it comes to reality is another story entirely.

 

By the way, someone mentioned the British health system, well this system is in serious difficulty for very much the same reason, too few paying (tax) and too many claiming (benefits), coupled with poor administration and doctors morale, the NHS has now pretty much collapsed.

 

I was forced to use the system in August last year on a business trip when I got a serious middle ear infection, even though I had medical insurance, I had to wait over 4 hours in a grubby run down facility to see a semi interested doctor who could hardly say good morning.!

 

Our public health is not good I agree, but its not that far behind the now present British situation in my experience.

 

porky2009-06-11 01:13:45

[AndreZA]

The middle class will eventually dissapear and become poorer

 

 

 

can someone explain where lower-class end and middle-class begins? Salary wise.

[Hog_]

 

spent the night after my recent accident in a state hospital. they x-rayed nearly every part of me. the aging eastern euopean doctor who examined me declared i had a broken nose and sent me home hours later. a day later' date=' after much discomfort, i went to the private hospital near my home?and then the list of injuries got longer and longer as the doctor picked up the stuff the first one missed.[/quote']

 

Well, the flip side:

 

Last time when I dislocated my shoulder I ended up at the Morningside Medi Clinic. Guys did one xray from the front where you could not see the dislocation, so the doctor sent me home with a few pain pills and a diagnosis for a sprained AC Joint. The specialist I saw the next day almost blew a fuse!

 

 

[PhilipV]

This probably will never leave the ground, and the Medical aid industry is too big to allow the government to close them down. Just make sure you have proper medical aid when/if this system is integrated.