THE number of principal members of registered medical schemes had increased to 3.3 million last September from 3.1 million in December 2007, according to the Council for Medical Schemes (CMS). An unnamed CMS source said the increase should be attributed to the fact that members were afraid of cancelling their schemes during the prevailing tough economic conditions. The source said people were scared of the reality of having to attend this country's public healthcare institutions, which were generally known to be in a poor state. The number of total beneficiaries had risen by 4.6 percent from 7.4 million in December 2007 to 7.8 million in September, the CMS said in a report. Aleksandra Serwa, the communications manager at CMS, confirmed that the council had seen an increase in the membership of medical schemes, but said it was very difficult to pinpoint the reasons why people joined medical schemes. Heidi Kruger, the communications manager at the Board of Healthcare Funders, said the organisation had not seen any increase in cancellations, but people were downgrading to more affordable options.
Mzwandile Jacks: Business Report, 25 February 2009
THE Health Professions Council of SA (HPCSA) has announced that doctors and certain other health professionals are to be allowed to own unlimited shares in private hospitals, but subject to strict conditions. The 160 000 professionals registered with the council, including doctors, dentists and psychologists, but not nurses or pharmacists, were previously allowed to own only ten percent of the shares in a private healthcare institution. The cap was set as a safeguard against over-servicing and self-referral. The council said in a statement that its ethical rules had been amended to remove the cap. This was however subject to a range of conditions, among them that the shares had to be bought at market-related prices, and that no conditions were imposed on the practitioner "that will detract from the ethical, good and safe practice of the profession". In addition, return on investment, or dividends, could not be based on patient admissions or patient servicing targets. The practitioner was not allowed to advertise or promote the institution, and could not "engage in or advocate" its preferential use. The practitioner would have to submit an annual report indicating the number of patients he or she had referred to the institution, plus the number referred to other hospitals. The HSPCA said a conspicuous notice would have to be displayed in the waiting room indicating the practitioner's financial interest or shares in the clinic or hospital. HPCSA registrar Boyce Mkhize said the council was confident the amendments would help maintain "transparent parameters" for healthcare practitioners. He said the public and practitioners could rest assured that ownership of a financial interest in hospitals would be closely monitored given possible abuse that might occur due to over-servicing and self-referral issues.
SAPA, 19 February 2009
FINANCE Minister Trevor Manuel has increased the amount you either receive as a tax-free subsidy from your employer or claim as a tax deduction for contributions paid to a medical scheme. From March 1, the amount you can receive as a subsidy or claim as a deduction for contributions paid for yourself and the first dependant you register on a scheme will increase by 9.6 percent, from R570 to R625 a month. The amount you can receive as a subsidy or claim as a deduction for any further dependants you register on a scheme will increase by 10.1 percent, from R345 to R380 a month. Late last year, medical schemes announced contribution increases for this year ranging from 6.1 percent to 16.7 percent. Discovery Health increased its contributions by 12.4 percent. The country's fastest-growing restricted medical scheme, the Government Employees' Medical Scheme, increased its contributions for 2009 by 11.18 percent. The Budget Review also announced that the government is considering a new way to treat your medical expenses for tax purposes. A consultation paper will be released later this year outlining the proposals. But the Budget Review indicates that the deductions for medical scheme contributions and other allowable medical expenses could be replaced with a tax credit or rebate of 30 percent of the deductions you are currently allowed. Franz Tomasek, SARS's general manager for legislation, gives as an example that in the 2009/10 tax year you will be able to claim a deduction of R24 120 (contributions for a family of four at R2 010 x 12) for medical scheme contributions, and, assuming you don't have any other qualifying medical expenses, your taxable income will be reduced by this amount. The effect this deduction will have on the amount of tax you pay depends on your tax rate. Under the proposed system, you would be allowed a tax credit or rebate equal to 30 percent of the R24 120, which would work out to R7 236 in this example. Tomasek says the proposed system will benefit middle- and lower-income earners, who are paying a marginal tax rate of less than 30 percent, and will be disadvantageous to those who are paying a higher rate. The debate around the proposed deduction is likely to be linked to discussions about the introduction of a National Health Insurance (NHI) system in South Africa. NHI is typically a healthcare system that offers health care to both those who contribute to the system and those who cannot afford to do so. In an NHI system, the government usually purchases healthcare services from providers other than the state. However, no two NHI systems around the world are the same, and the government has yet to formulate the details for a South African system. Health Minister Barbara Hogan told Parliament earlier this week that while there was likely to be much debate around a suitable NHI for South Africa, the rationale for introducing NHI "can never be surely more persuasively argued now, when we face the critical funding shortages that we have here".
Laura du Preez: Personal Finance, 14 February 2009
THE government has set aside an extra R930m for its HIV/AIDS programmes over the next three years, reflecting its plans to double the number of people on treatment and improve the quality of services for preventing mother-to-child transmission of the virus. Conditional HIV/AIDS grants to provinces are set to rise from R3,48bn in 2009-10 to R4,31bn in 2010-11 and R4,63bn in 2011-12. Conditional grants are transferred to provinces via the Health Department, and are earmarked for a specific purpose. The treasury's most recent figures show that 630 000 patients with advanced HIV had started treatment by October. By 2011-12, the government expected domestic resources and donor funding would allow HIV/AIDS drugs to be provided to 1,4-million people, said the Treasury's director for health policy Mark Bletcher. SA has one of the world's worst HIV/AIDS epidemics, with 5,7-million infections. The bigger HIV/AIDS budget also takes into account the increased costs of introducing a more effective drug regimen for preventing mother-to-child transmission of the HIV virus, which involves using two drugs instead of one. Dual therapy was expected to bring the transmission rate down to less than 5%, said Bletcher. The government also intended to make sure that the services were available to more women, he said. Bletcher said the government's resources for HIV/AIDS would be complemented by donor funding, which together were likely to total more than R12bn a year. Consolidated annual government health expenditure is set to rise by an average of 9,2% between 2008-09 and 2011-12. Over the next three years, the budget will rise from R86,9bn in 2009-10 to R97,6bn in 2010-11 and R105bn in 2011-12. Spending priorities emphasise the government's plans to combat the twin epidemics of HIV/AIDS and tuberculosis, reduce child and maternal mortality, and improve the quality of services provided at hospitals and clinics. Additionally, R1,8bn has been earmarked for three new vaccines against potentially lethal childhood infections. Another R3bn has been set aside to increase pay for doctors, specialists, dentists, emergency services staff and pharmacists, in a bid to retain these skills in the public sector. Final details of the new pay structure were still under discussion, but this "occupation-specific dispensation" was expected to be implemented within the next few months, said Bletcher. The budget includes an extra R50m for dealing with the cholera epidemic, which has infected more that 8 500 people. An additional R728m has been allocated to revamp hospitals. This conditional grant will be used to build new hospitals and upgrade existing facilities in the country, and has risen from R1,1bn in 2005-06 to R4,2bn in 2011-12. There was also R22,5m allocated to the new National Office of Standards Compliance, which will set and audit standards for clinics and hospitals. Two dozen hospitals have been assessed so far, and a national audit of primary healthcare facilities is being planned. In addition, R44,5m has been allocated to, the new Medicines and Health Products Regulatory Authority, which will replace the Medicines Control Council. The authority is also expected to raise its own funding from collected fees. The Health Department also plans to spend R30m on a national tuberculosis prevalence survey, improve the cure rate and increase efforts to track down patients who have stopped taking their medication, said Bletcher. The department had managed to trim R123m over the medium-term in areas where it has historically underspent, most notably in its goods and services budget, said Bletcher.
Tamar Kahn: Business Day, 12 February 2009
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