Doctors will close practices if NHI is implemented

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tRoN said:
How do you know ?
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In SA doctor either work for the state or have their own practice, it's law.
When you go to hospital, you pay seperately for the visit, doctor, anaesthetist etc, and every one of them will extract the maximum they can from you.
There would be proper competition if e.g. discovery had their own GP's charghing set fees and not this 200% cover BS.

tRoN said:
And lawyers don’t fleece their clients ?
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Strawman
 
The Darkness said:
Rubbish. People who solve big problems deserve compensation.
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Maybe re-read my post, I did not claim that they do not deserve compensation.
It is not a free market however, the HPCSA does not allow private companies/hospitals to employ doctors.
 
Craig_ said:
Nope, you're exactly there to compensate him for that, unless you want to go to a sangoma for medical advice, you'll be expected to compensate him for that. And considering how many lives doctors saves every day it's worth every cent. You can always go to a government hospital to see how it's done cheaply, and then see what you prefer.

Nobody forces you to take out medical aid, and no one forces you to go to a doctor, you do that of your own free will.
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Once you remove the free market from an industry, you remove choice from the consumer. So the options you mention are because of a broken system and consumers are being forced to choose between the unaffordable option, the quackery of "traditional" medicine or the disaster that is state medical care.

Similarly to the local auto industry where subsidies and all sorts of financial mumbo jumbo (The Automotive Production and Development Programme, Productive Asset Allowance (PAA) and the Import-Export Complementation among others) keeps them in business at the expense of the taxpayer. Legally you cannot import a new or used vehicle to protect the local industry. So even the cheapest nastiest vehicle sells for an eye watering amount locally.

So you are wrong. The system forces me to take out (increasingly unaffordable) medical aid, it's not my free will.

Just so we are clear, are you in the medical profession?
 
Velskoen said:
True yes. I was comparing the current system to the proposed NHI, between the 2 of which the current system is better. But you are quite correct saying that it leaves much to be desired. It needs a huge overhaul with the total medical and pharmaceutical industries being redesigned. How? I don't know.

Friend of mine with 3 kids is paying R16k pm. I too am self employed and I pay an obscene amount for medical cover for my wife and I. Despite benefits being reduced each year. I have no idea what employees pay for medical cover but whatever it is, it's becoming unaffordable for most people.
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It doesn't need a redesign. It simply needs to have the right incentives. What I would do:
1) Create primary care health plans and have them be tax deductable. This can either be insurance based, or direct care based (basically you pay your doctor's practice a monthly fee directly). Ditto for dental plans. Or a combination of each.
2) This one is a shocker, but it would be to allow hospitals to employ doctors and operate as a healthcare business instead of a property, equipment and nurse rental business. And yes, that is what a hospital is in South Africa. There is a monstrous duplication of administration in all hospitals because the specialists operate as individual businesses, rather than as employees of a hospital group.
Law should allow a hospital to employ or contract out its doctors.
3) Break up the PMBs into a number of categories that are clearly defined, and any hospital plan/medical aid offering those plans must state the highest category of benefits the plan covers. Start at 1) which just covers emergency room visits for example. And move up to 2 , 3 ,4 and so on.
4) Allow private sector to build and operate private medical and nursing schools.
5) Require all healthcare providers to provide transparent pricing for all the services they provide, in their practice and on their website if they have one.

Other than this, growing the economy is the best way to solve the healthcare problems in SA.
 
konfab said:
It doesn't need a redesign. It simply needs to have the right incentives. What I would do:
1) Create primary care health plans and have them be tax deductable. This can either be insurance based, or direct care based (basically you pay your doctor's practice a monthly fee directly). Ditto for dental plans. Or a combination of each.
2) This one is a shocker, but it would be to allow hospitals to employ doctors and operate as a healthcare business instead of a property, equipment and nurse rental business. And yes, that is what a hospital is in South Africa. There is a monstrous duplication of administration in all hospitals because the specialists operate as individual businesses, rather than as employees of a hospital group.
Law should allow a hospital to employ or contract out its doctors.
3) Break up the PMBs into a number of categories that are clearly defined, and any hospital plan/medical aid offering those plans must state the highest category of benefits the plan covers. Start at 1) which just covers emergency room visits for example. And move up to 2 , 3 ,4 and so on.
4) Allow private sector to build and operate private medical and nursing schools.
5) Require all healthcare providers to provide transparent pricing for all the services they provide, in their practice and on their website if they have one.

Other than this, growing the economy is the best way to solve the healthcare problems in SA.
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Sounds like it could work. That No 5 is the bane of my life. Like cellphone contracts, I get a headache trying to understand the terms of my medical aid plan. They make them as complicated as possible so people just go for what they can afford and find out what isn't covered when it comes time to claim.
 
kolaval said:
It is not a free market however, the HPCSA does not allow private companies/hospitals to employ doctors.
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The company I work for most definitely have more than one medical doctor employed at our medical station.
 
rvZA said:
But they do. They make Trillions. Hence the reason government is closing them down. If they are not a profitable company, they would have no problem giving this sector to government.
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You do not know what you are talking about. Read up a little bit more about how medical aids work before you make a comment like this. Also trillions? Do you know what a trillion is?
 
geezer said:
The company I work for most definitely have more than one medical doctor employed at our medical station.
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As can be seen from paragraph 2.2, a healthcare practitioner may not transfer any funds earned from patients to a corporate entity and a professional practice may not be owned (directly or indirectly) by any other person than a registered healthcare practitioner. A medical professional’s practice can only be established by one or more medical practitioners and direct or indirect corporate ownership of that practice is prohibited therefore indicating that a private hospital may not employ a healthcare practitioner.

Furthermore, paragraph 2.4 of the Policy Document is more specific as it indicates who may be employ a medical practitioner. Paragraph 2.4 reads:
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https://www.lexology.com/library/detail.aspx?g=1c3391d2-1e64-4fef-99b3-d9d5c51cea73

Can a regular person go to that doctor for services, and pay the company? Answer is no.
 
Velskoen said:
Sounds like it could work. That No 5 is the bane of my life. Like cellphone contracts, I get a headache trying to understand the terms of my medical aid plan. They make them as complicated as possible so people just go for what they can afford and find out what isn't covered when it comes time to claim.
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Well 5 is sort of addressed by a broker.
 
rvZA said:
Some people still do not understand the hierarchy of Communism.... it all starts with democracy.
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I think you are the one who does not understand communism. There is absolutely no trace of democracy involved. Go ask the people of Eastern Europe - they will tell you how they suffered under communism and how difficult it was to get rid of the communists.
 
It's not that hard to find a doctor who doesn't charge an arm and a leg.
People are just too lazy to drive a little but further or to drive into another suburb.
Or to visit suburbs that are slightly lower class.
Or to sit with people in a waiting room that are not the same ethnicity as themselves.

There are very good doctors out there... but people are snooty and pay the high prices because they like to get shafted.
My doctors offices are in an industrial area.
He services clients who are mainly black and who are mainly referrals from Workman's comp.
There are no appointments, you just go sit in the waiting room and take your turn.... but you never wait longer than 30 mins.
But his rates are very reasonable and he knows what he is doing. He used to be the administrator of a major Government hospital (before he left due to all the corruption).
 
kolaval said:
In SA doctor either work for the state or have their own practice, it's law.
When you go to hospital, you pay seperately for the visit, doctor, anaesthetist etc, and every one of them will extract the maximum they can from you.
There would be proper competition if e.g. discovery had their own GP's charghing set fees and not this 200% cover BS.


Strawman
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What you're talking about is what's already happened in the US. Big companies buy out all the doctors, open their own chains and then set their own prices which are a LOT higher than what they used to be before.
 
Stonemason said:
I think you are the one who does not understand communism. There is absolutely no trace of democracy involved. Go ask the people of Eastern Europe - they will tell you how they suffered under communism and how difficult it was to get rid of the communists.
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None so blind as those who do not want to see....
 
rvZA said:
None so blind as those who do not want to see....
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I have actually seen it. I have actually spoken to the people who suffered under the misguided theories of Messrs. Marx and Engels. One thing they have not taken into account was the question of incentive. If everybody gets paid the same, what is the incentive to better yourself and to work harder?

That is exactly why the NHI will never get off the ground. If you take away the incentive of a doctor, he is going to go to a country where he will be able to better himself and earn more money. With him, he will take his money and the jobs that he provided here in South Africa. In the end all that will remain are those paramedics trained in Cuba who call themselves doctors. And the only reason they will remain is because no country in the world (not even Cuba) will be prepared to let them loose on their sick people.
 
Doesn't matter, we closed down Diagnostics Divisions in hospitals as our ML algorithms were better at doing their jobs. We have a suturing machine (partnering with SA hospitals to trial this out) that runs on AI and Vision systems. Doctors aren't safe from tech anyway let alone NHI.
 
Well there's a couple muppets in here who are clearly looking forward to the NHI ...... to you: :ROFL:
 
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