Med­i­cal aids cause doc­tor short­ages

Weekend Argus (Saturday Edition) - - COMMENT -

A RE­PORT by the Med­i­cal Pro­tec­tion So­ci­ety, an in­sur­ance com­pany that cov­ers doc­tors against med­i­cal neg­li­gence claims, that the rise in med­i­cal claims dis­cour­ages doc­tors from spe­cial­is­ing, ig­nores other ma­jor causes. Health Min­is­ter Dr Aaron Mod­soaledi said there are six doc­tors for ev­ery 100 000 peo­ple; the ideal is 15 doc­tors.

Pro­duc­ing more doc­tors will not solve the prob­lem be­cause half SA’s reg­is­tered doc­tors have left the coun­try. Rea­sons in­clude: the state’s fail­ure to fill va­can­cies due to a lack of funds; poor work­ing con­di­tions and lack of proper equip­ment and long work­ing hours. There is also the high ad­min­is­tra­tive fees of many low-cost health care and man­aged-care com­pa­nies.

The pri­vate sec­tor is los­ing thou­sands of doc­tors to over­seas coun­tries be­cause low-cost med­i­cal aids have made it im­pos­si­ble for them to sur­vive on the fees they pay and of their strin­gent rules and the or­deal doc­tors have to go through to ob­tain au­tho­ri­sa­tion from med­i­cal aids for pro­ce­dures and chronic con­di­tions. Th­ese schemes have short-changed their mem­bers, making good med­i­cal care dif­fi­cult.

One par­tic­u­lar low-cost med­i­cal aid charges its mem­bers R6 000 a year for GP vis­its only and expects GPs to see their pa­tients about 2.4 times.

Its ad­min costs are 80 per­cent and it al­lo­cates its mem­bers 20 per­cent. GPs who go be­yond the 20 per­cent are chas­tised by man­aged-care risk man­agers, who don’t have the slight­est clue about proper health­care.

For GPs to be able to ren­der a good ser­vice and to sur­vive at their low rates, the num­ber of vis­its should be about six a year, es­pe­cially in treat­ing non-com­mu­ni­ca­ble diseases like diabetes, asthma and heart con­di­tions.

Be­fore we in­vest more money pro­duc­ing doc­tors for the over­seas mar­ket, we should se­ri­ously look at the high ad­min costs of many of our med­i­cal aid schemes.

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