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The possibility that doctors will be demanding cash upfront from insured patients from July 1 is terrible news. People are struggling to make ends meet and medical insurance is not cheap by any measure.
To then have to scrounge around for cash for consultation means that many people would go without medical attention, even in critical situations.
This is in addition to shortfalls that have become the order of the day. People are ending up with huge bills to settle even though they have medical insurance. This is because most packages on offer have very limited cover. But for many ordinary people the premiums are very high. Many organisations can no longer offer medical aid cover subsidies to employees and the majority of individuals in the country are not formally employed.
There is just no way that the majority of such people can then fork out cash for doctors’ consultation fees. The situation is untenable and a solution must be found urgently. It is very tempting to blame the doctors for adopting such a seemingly callous attitude that is contrary to the Hippocratic Oath.
But it is more productive to consider that doctors are only one component of the health delivery system and their stance is an indicator of deeper problems. What if other service providers like hospitals also resolve to only accept cash say for admission, theatre procedures and other services?
Pontificating about the moral duty of doctors will not solve the crisis. We need to look at the broad picture if we are to find a sustainable solution. All factors that have brought us to this point have to be considered in a sober manner.
The cost of medical services in this country is too high and therein lies the problem. Why should specialists service providers charge figures above the poverty datum line for a single procedure normally carried out within a couple of hours?
Does this mean that they are saying their skills are only reserved for the elite and the poor might as well die at home if they are unfortunate enough to contract conditions that need specialised medical attention?
These high costs are pushing people to seek specialist attention in places like India and South Africa. It appears that travel and hospital bills not withstanding, it is cheaper to access specialised medical services in those countries than locally. This is a direct and indirect cost to the economy as we keep on financing the developments of other nations at the cost of our own.
Medical insurers themselves need a major change in their business models if they are to remain relevant. Medical aid societies have to cope with increasing numbers of clients with chronic ailments due to HIV and non-pandemic diseases. This calls for an out of the box solution to funding operations beyond member contributions.
Otherwise they will find that people without chronic conditions will opt to self-insure and consider alternatives like hospital cash back plans instead of traditional medical aid.
Premier Service Medical Aid Society had set on a great path under the tenure of Cuthbert Dube when the insurer ventured into service provision. Unfortunately that gentleman was not so innovative in creating robust corporate governance systems that would have protected the society from wholesale looting. Today, the society is just another example of how not to do business.
Government also needs to play its part in funding the public health delivery system and rooting out corruption.
There have been many media articles about officials at public health institutions flouting procurement procedures and siphoning off money, but we are yet to hear of prosecution and restitution.
The populace is being sacrificed by individuals who loot institutions that should be serving the most vulnerable in society. The responsible authorities must bring sanity to the health delivery system as a matter of urgency.
Online Reporter