Motsoaledi lashes hospital association for ‘fear-mongering’

● Aaron Motsoaledi, the minister of health, has hauled the Hospital Association of SA (Hasa) over the coals, saying it is using fearmongering to fight the implementation of National Health Insurance (NHI).

This comes after the association’s warning last week at Business Unity SA’s Business Economic Indaba that thousands of jobs were at stake due to contradictions in the NHI and Medical Schemes Amendment Bills.

“Now they are saying ‘if you implement the NHI, you are going to lose jobs’. So this is targeted at the trade union movement to start fighting us,” Motsoaledi said on Thursday night after President Cyril Ramaphosa’s state of the nation address.

Hasa’s presentation at the indaba was based on research it commissioned from Econex, whose findings were based on two scenarios that would have an effect on SA’s economy. The first scenario suggested that the government would not approach private hospitals to purchase services, which would result in the loss of 99,600 jobs in the private sector. The second scenario found that capping prices at 23% as per regulation would result in 132,000 job losses, according to Business Day.

Motsoaledi also accused Hasa of using the threat of job losses to stymie the work of the health market inquiry (HMI) — chaired by former chief justice Sandile Ngcobo — that is looking into features of the private healthcare sector that prevent, distort or restrict competition.

“His [Ngcobo’s] preliminary inquiry is yes, this pricing [for health care] is exorbitant, it needs to be regulated. They [Hasa] know that [it] might come up in the final report. What instrument do you use to fight it? Jobs, [to] get people to stop Ngcobo. In other words, South Africans must believe that for them to get jobs, health care must be expensive. What type of logic is that?” asked Motsoaledi. He added that the NHI was for the whole country and the public sector would purchase services from the private sector.

He also lashed out at Econex, saying: “[They] are guns for hire ... Anybody who hires them to do research, they will produce the results that person wants. I’m very angry with them when they do flimsy research and start fear-mongering.”

The HMI released its preliminary report last year and is set to release the final version this year.

Both Motsoaledi and his spokesperson, Popo Maja, said they had not seen the Econex report.

Hasa and Econex declined to share the research with Business Times, citing confidentiality.

After the media report and Motsoaledi’s comments, Hasa denied it had said the NHI posed a threat to jobs and said it was instead referring to “many economic sectors”.

Hasa spokeperson Mark Peach said: “The central question addressed [at the Business Economic Indaba] was how we can together [private and public sector] stimulate national economic growth. Participants also addressed economic growth constraints.

“One such constraint is policy uncertainty, not only for health care but for many economic sectors. The Hasa presentation covered the draft Medical Schemes Amendment Bill and the NHI Bill and the ways the two bills contradict each other and contribute to policy uncertainty.”

The contradictions were with regards to the Medical Schemes Amendment Bill, which stipulates that medical aid schemes will not offer benefits offered by the NHI fund. Peach said the question was whether this meant medical aid schemes will not be covering the bulk of private hospitalisation.

He also raised a question about what the purchasing of hospital services in the NHI meant since the NHI Bill states that the NHI Fund will purchase hospital services exclusively from the public sector until the end of 2026. It is not clear what happens thereafter.

Paula Armstrong, a senior economist at Econex, said: “There is substantial uncertainty about the future format of health-care provision under NHI, and the NHI Bill and Medical Schemes Act Amendment Bill contradict each other in ways that have significant ramifications for the private sector.”

In his state of the nation address, Ramaphosa said the NHI Bill would soon be ready for submission to parliament. Motsoaledi has previously said that NHI will be implemented in 2030.

I’m very angry with them when they do flimsy research

Aaron Motsoaledi

Minister of health