Harnessing the Power of Now
The time has come for the Board of Healthcare Funders (BHF) and the medical scheme industry to be acknowledged as major players in the South African healthcare environment.
This is the opinion of Dr Humphrey Zokufa, Managing Director of the BHF as he prepares for the annual BHF conference to be held in the Drakensburg in late July.
“It is time for the industry to assert itself,” he says. “We play a pivotal role in the private healthcare sector, and we are ready to play an equally important role in the government’s proposed National Health scheme.”
This year’s BHF Conference theme is ‘The power of Now: Into the changing future’. Zokufa and his Board have three main powers in mind when they refer to ‘The Power of Now’.
The first lies in the power to channel the revenue into the private healthcare industry.
“If we did not collect the contributions, there would be no private healthcare industry. We are responsible for 8.2 million lives, and we are mandated by government to manage these contributions judiciously and prudently.
“That leads on to our second power. We have the power to wisely spend what we have collected,” he says.
It is in the third power that the future lies. The skills and expertise of the members of the BHF are a formidable resource, and one that should be tapped, to ensure that the NHI is a success.
“The private healthcare industry is a national asset which should be used as the healthcare system in South Africa is transformed,” Zokufa points out. “We have the core skills and expertise that are going to be needed. The work we are doing for 8.2 million people is going to have to be built on in order to manage over 49 million lives.”
Zokufa sees the advent of NHI as a positive move for the industry. He is confident in the government-mandated role of medical schemes which “were established by an Act of Parliament” and believes that more opportunities and more jobs will be created within the sector as NHI rolls out.
“When it comes down to it, NHI will be like a very big medical scheme. The issues and concerns that we are facing now will be the same issues faced by NHI unless we solve them now.”
Top of the list of those concerns is the constitutionality of the interpretation of Regulation 8 of the Medical Schemes Act. It is this regulation which declares that medical schemes must pay in full for the diagnosis, treatment and care of all conditions covered by Prescribed Minimum Benefits.
Advocate Isabelle Ellis will be examining whether PMBs align with Constitutional principles and how they should be reviewed to be in line with National Health Policy. She’ll also be looking at whether the Council for Medical Schemes has a responsibility to publish a tariff and provide insight into the quantum of that tariff..
Taking the stage at the opening ceremony will be Dr Zweli Mkhize, the Premier of KZN and member of the ANC NEC.
For the second year the conference will be addressed by Dr Aaron Motsoaledi, the Minister of Health.
“When he addressed us last year, the Minister challenged us to look at ways in which we could play a constructive role in the transformation of the industry,” Zokufa says. “I believe we are meeting that challenge, and I am looking forward to hearing what the Minister will say this year.”
Andy Rice, probably South Africa's best-known branding and advertising expert, will provide a lively and dynamic opening address on Sunday the 29th July on strategies to improving perceptions of the healthcare funding sector.
Other programme highlights include:
· Mandatory cover – A cornerstone of social solidarity
· Personal Medical Savings Accounts – their role in the industry
· The solvency debate – examining the parallels with the short-term insurance industry; the reserve ratio required if medical savings accounts were removed; the correct manner in which to assess the correct reserve ratio for different schemes; and, the impact of the reserve requirement on contributions
· The Protection of Personal Information Bill – the impact to medical schemes
· Turning a ‘grudge purchase’ into a ‘desired purchase’ - tools for improving perceptions of the funding industry
· NHI pilot sites – the private sector role?
· Learning from our SADC counterparts – a well functioning HMO model in Zimbabwe
· The direction of specialized health care services in South Africa - time to change tack?
· Fraud – what we can learn from the rest of the world and how can we minimise the cost of fraud
· Predictive modeling applied to high-risk beneficiaries and the financial outcomes of facilitated disease management
· The use of research information by medical schemes in health risk management
· Pharmaco economics and medical scheme benefit design
“The conference focuses on getting us from where we are to where we want to be,” Zokufa says. “I am sure that delegates will leave the conference feeling motivated and enthusiastic about what the future holds. I’m certainly inspired and excited about where we are heading as an industry.”
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