Com­mis­sion starts in­quiry into health­care costs

CityPress - - Business - JEANNE VAN DER MERWE jean­nevd­merwe@me­

For­mal in­ves­ti­ga­tions into the cost of health­care in South Africa have fi­nally started as part of the Com­pe­ti­tion Com­mis­sion’s lon­gawaited in­quiry.

The wide-rang­ing in­quiry, led by re­tired Judge Sandile Ng­cobo, seeks to es­tab­lish the un­der­ly­ing rea­sons for the dra­matic in­crease in pri­vate health­care costs over the past decade.

With terms of ref­er­ence en­com­pass­ing ev­ery as­pect of the pri­vate health­care sec­tor – from med­i­cal aids, ad­min­is­tra­tors and bro­kers, to doc­tors, spe­cial­ists, hos­pi­tal groups, and drug and equip­ment sup­pli­ers – there is con­cern that the com­mis­sion may not com­plete its work by the dead­line, which is Novem­ber next year.

These fears were height­ened when the pri­vate hos­pi­tal group Net­care filed a suit against the com­mis­sion and its tech­ni­cal part­ner, KPMG, late last year, os­ten­si­bly be­cause it feared KPMG would give con­fi­den­tial in­for­ma­tion ob­tained while do­ing work for Net­care to the com­mis­sion.

A rul­ing in this mat­ter is pend­ing in the South Gaut­eng High Court.

Heidi Kruger of the Board of Health­care Fun­ders said: “We agree that the dead­line is tight. How­ever, we be­lieve that the com­mis­sion should not com­pro­mise the in­quiry, but rather take the time it needs to com­plete the work fully, even if it takes a bit longer.”

Non­govern­men­tal or­gan­i­sa­tions Treat­ment Ac­tion Cam­paign and Sec­tion27 have both crit­i­cised Net­care’s law­suit as an at­tempt to frus­trate the com­mis­sion’s work, although Net­care has de­nied this was the case.

The in­quiry direc­tor, Clint Oellermann, ac­knowl­edged that Net­care’s law­suit had af­fected the in­quiry be­cause it had to iden­tify and ap­point al­ter­na­tive ser­vice providers as a re­sult.

“The work of the in­quiry must go ahead, and has gone ahead, although the com­mis­sion has had to put con­sid­er­able time to­wards putting in place al­ter­na­tive ar­range­ments to fa­cil­i­tate the work of the in­quiry,” he said.

He added that KPMG’s skills and ex­per­tise were “still con­sid­ered im­por­tant for the in­ves­tiga­tive phase of the in­quiry”.

Oellermann said the panel was bound by the time frames of the terms of ref­er­ence, but the com­mis­sion had the power to ex­tend the in­quiry if nec­es­sary.

The panel stated ear­lier this year it would in­ves­ti­gate var­i­ous re­la­tion­ships in the pri­vate health­care sec­tor. Among the fac­tors it would con­sider are:

The pow­ers dif­fer­ent play­ers in the in­dus­try have over one another, and how these in­flu­ence costs and prices;

The re­la­tion­ships be­tween hos­pi­tal groups and spe­cial­ists, in­clud­ing share­hold­ings and ac­cess to spe­cialised equip­ment;

Ex­ist­ing ar­range­ments that pre­vent new play­ers from en­ter­ing the mar­ket;

How ex­ist­ing laws and reg­u­la­tions in­flu­ence be­hav­iour of dif­fer­ent play­ers in the mar­ket; and

Whether in­suf­fi­cient in­for­ma­tion, such as ad­vice pro­vided by bro­kers aligned to cer­tain med­i­cal funds, or from doc­tors or spe­cial­ists re­gard­ing avail­able treat­ment op­tions, may in­flu­ence the choices pa­tients make.

The in­quiry is re­ceiv­ing writ­ten sub­mis­sions be­tween now and the end of Oc­to­ber.

It will then con­sider the sub­mis­sions un­til the end of Jan­uary, with pub­lic hear­ings sched­uled for March and April next year, fol­lowed by anal­y­sis of the in­for­ma­tion and tar­geted pub­lic hear­ings from the begin­ning of May un­til the end of July.

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