Medical aids cause doctor shortages

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.