Health Market Inquiry – analysis of the private healthcare market

Health Market Inquiry – analysis of the private healthcare market

Brian Ruff, our founder presented to the Health Market Inquiry on 17 May 2016.   He presented an overall analysis of the private healthcare market in South Africa and PPO Serve’s vision for how it can be reformed to improve healthcare outcomes and efficiency.

He explained that a different narrative is necessary in order to ensure affordable and efficient healthcare delivery in South Africa. The current narrative largely ignores the poor performance of the healthcare system in terms of both its efficiency and healthcare outcomes.  The result of an under-regulated private healthcare system was ultimately high premiums for patients and lower than desirable quality of care.

An Article on Section 27 summarises the presentation:

Ruff continued to explain that although ultimately a “unified” healthcare system is necessary, the process of producing National Health Insurance (NHI) has thus far lead to a “regulatory vacuum” and effectively stifled some key regulators. Overall, PPO Serve, in the short term, is advocating for a “competitive solution” which will crucially require the stimulation of competition on the “supply side” (between healthcare providers) based on value and in a manner that is “accountable”.

 

PPO Serve’s suggested regionalised system would, according to Ruff, by operated through “branded healthcare systems” with “multidisciplinary teams” including a variety of healthcare professionals working together to produce the quality health outcomes. These teams and regional systems would be able to define value to sets of consumers accurately by taking into account 1) population need, 2) measured patient outcomes and 3) costs.

The full presentation can be found here: Competition Commission pres – 10May2016 – final2

America’s epidemic of unnecessary care rings true in South Africa

America’s epidemic of unnecessary care rings true in South Africa

Important follow up to the Cost Conundrum in 2009, Atul Gawande’s Overkill has enormous relevance for the SA private healthcare sector which shares these issues and needs similar solutions.

The crux is the overall well-being that patients value (‘patient centered care’) gets lost under a tidal wave of services, many not needed or even harmful.  The anxieties, structures and incentives that cause this is well explored. The successful reform stories with better quality, less costs and improved doctors working lives, all rely on integrated teamwork and outcome measures and are very straight forward. Financial rewards must fund value for populations, not services for individuals.

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