The Health Market inquiry (HMI) established by competition commission to investigate South Africa’s private healthcare market released its provisional report on 5th July 2018 in the presence of the Minister of Health, media and stakeholders from healthcare sector. The HMI was chaired by Judge Sandile Ngcobo, a retired Chief Justice of the Constitutional Court.
The Commission after 4 years of detailed investigation and multiple stakeholder consultations concluded that: Private health market is characterized by high and rising costs of healthcare and medical scheme cover; disempowered and uninformed consumers; and ineffective regulation and failures of accountability at many levels. The 808 page provisional report makes several interesting findings and lists out some recommendations including (but not limited to): Establishment of a supply side regulator to set the rules of the game and scrutinize the private sector: Measurement and Public reporting of health outcomes by the private providers to improve competition and inform patients about quality of care; Replacement of Certificates of Need with hospital licences for equitable spread of facilities across the country.
An earlier study conducted by Organization for Economic Co-operation and Development (OECD) and WHO on the costs of healthcare in South Africa acted as one of the key catalyzers for the HMI investigations and findings. The OECD-WHO study pointed out that the costs of healthcare in South Africa are comparable to those in the OECD countries, whilst the purchasing power of people in South Africa is much lower than those of the OECD countries. Thus private healthcare is only affordable for around 10% of the South African population.
Overall the findings were very well received by most of the stakeholders as it was clear that it could rid the system of anomalies in the voluntary health insurance and private health provider sectors. It also comes at an opportune time when the draft National Health Insurance (NHI) Bill and Medical Schemes Amendment Bill are also out for public comment. These are all complimentary and building a strong case for NHI related health systems reforms in South Africa that could help move the country towards Universal Health Coverage.
The detailed report of the Health Market Inquiry, executive summary and other documents are available at the following website http://www.compcom.co.za/provisional-findings-and-recommendations-report/. HMI will receive public comments until the 7th of September 2018. Based on public comments, the final report is likely to be published towards the end of November 2018. WHO will continue to support the process of HMI and implementation of its final recommendations with NDoH and other key stakeholders.