Competition Commission gets private healthcare reform ball rolling | Citypress

Getty ImagesA year after the Competition Commission released its Health Market Inquiry report, there has been very little action in addressing the report’s findings. Now, a notice the Competition Commission sent to stakeholders in September suggests there may finally be some movement.

He confirms that the Competition Commission has started the process to establish the forum and was engaging with various stakeholders, including the health department. There is, however, no specific timeline for implementation yet.Covid-19 brought public and private health sectors together but what does the future hold?Makunga explains that the funder side of the private healthcare sector, namely the medical schemes and the administrator market, is regulated through the Medical Schemes Act.

“The HMI will thus issue an update to stakeholders as soon as these engagements have progressed,” the notice reads.Pricing and licencing are the biggest ‘messes’ Pricing or the appropriate tariffs for the private sector to charge for services used to be determined by the Representative Association of Medical Schemes , now known as the Board of Healthcare Funders, says Bhengu. This ended in 2004 after the Competition Commission found this to be anti-competitive.

The CEO of the SA Private Practitioners Forum , Dr Chris Archer, says the department was taken to court in 2010 for failure to publish the list for that year. The lists from 2007 to 2010 were consequently declared illegal and scrapped.This, says health policy analyst at the SA Medical Association , Shelley McGee, caused a vacuum to develop.

The purpose of the forum is to bring certainty around pricing, Bhengu explains, by setting fixed rates for Prescribed Minimum Benefits and a reference tariff list for everything else. CMS spokesperson Mmatsie Mpshane told Spotlight that the forum will be effective in bringing down healthcare costs and introducing the price regulation that is currently missing in the industry.

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