“In the unfortunate event that you are in a motor vehicle accident, would you be OK with the ambulance taking you to the closest public-sector hospital?”
I posed this question to an audience of about 300 people at our recent Healthcare Insights Summit. It comes as no surprise that most answered “no”. In fact, only one person said they were willing to do so.
What came as a surprise was that this person is a member of the Momentum Health Solutions team, with access to unlimited private health-care cover, begging the question: why would they willingly choose to go to a public hospital?
We found that this person is actively involved in the health-care sector and understands that in a trauma situation, there are pockets of brilliance at public institutions such as Johannesburg's Chris Hani Baragwanath and Charlotte Maxeke academic hospitals. They know that in such a situation, they will get world-class care at these institutions.
Collaboration between the public and private sectors will be key when assessing the operational rollout of National Health Insurance (NHI) and related funding models. By looking at the data and statistics, we can contextualise the disparity that exists.
There are 60-million people in South Africa, about 9-million of whom are members of a medical aid scheme. In the public sector, we have 243,684 health-care workers, indicating that each is responsible for about 209 patients. In contrast, the private sector has 360,274 health-care workers, each of whom is responsible for only 24 patients on average. There are 422 public-sector hospitals, averaging 120,853 patients, compared with 215 private-sector facilities with, on average, 41,680 people per hospital.
The framing of the NHI is that all 60-million South Africans will be treated as equal and make use of standardised healthcare offerings. However, the reality is that this is not operationally feasible and likely to encounter numerous legal challenges in its implementation
This is unsustainable and we recognise we must remove some of the burden from the state in the short term. The current framing of the NHI is that all 60-million South Africans will be treated as equal and make use of standardised health-care offerings. However, the reality is that this is not operationally feasible and likely to encounter numerous legal challenges in its implementation.
We believe there is a more practical way to achieve universal access to health care.
There are 6-million employed people who are not covered by private-sector medical aid. Data developed by BankservAfrica show the average nominal take-home pay in May 2023 was R14,457. If we add 6-million employed people to affordable health-insurance products at much lower premiums, they would enjoy day-to-day medical benefits, emergency and accident cover, and other benefits.
We would potentially move an average of 15,000 people per hospital from the public to the private health-care sector.
In turn, if we can tackle our jobless rate and bring more people into formal employment, we can further shift the burden from the state and create demand for private-sector health-care professionals.
This incremental approach allows us to improve access to public-sector health facilities, retain skills across public and private-sector stakeholders and, importantly, build a collaborative relationship with government, rather than further entrenching ideological positions.
While the NHI is an emotive subject, we believe it will be incorporated into existing medical schemes as they innovate around low-cost funding models. This will create a sustainable value proposition for end users who will benefit from technology, healthier lifestyles supported by enhanced access to health care and capacitated provider networks.
As one of the leading providers of health-care solutions in South Africa, we are confident the NHI debate will enter an encouraging new phase which will establish implementable, incremental wins. We look forward to contributing to a healthier ecosystem for all and, in doing so, creating access to more health care for more South Africans, for less.
McHugh is executive head: marketing at Momentum Health Solutions
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