# New National Health Insurance (NHI) will hijack private hospitals.



## vegasboy (Apr 28, 2010)

Medi-Clinic is slowly but surely moving their capital out of the country. I predicted this more than a year ago, no rocket science though, as they have been doing this for some time now. Other private hospitals will surely follow suit in time to come.

June 2010: (See their website for more):

“Shareholders are advised that the Board of Directors of Medi-Clinic ("the Board") has resolved to raise equity capital for the Company by way of a rights offer for an amount of approximately R1.4 billion ("the Rights Offer"). 

Rationale for the Rights Offer 

The proceeds of the Rights Offer will be used to finance growth opportunities available in Switzerland. These growth opportunities present themselves through expansion projects where capacity constraints or specific market opportunities exist at a number of hospitals, in particular Klinik Hirslanden in Zurich, Klinik St. Anna in Luzerne, Clinique Bois-Cerf in Lausanne and other smaller projects which will enable the Company`s Swiss operations to continue on its current growth path.”

Why are they doing this? With the new NHI government will provide a mandatory “medical scheme” to the whole population of 45 million plus, regardless of income. Most people will not be able to afford both and will be forced to go with the NHI, for which you will pay according to income (I’ve heard talks of 5% of gross salary), and will be collected by SARS. 

This means that the current less than 7 million people having access to medical aid schemes will decrease immensely, by a few million I guess, making it impossible for private hospitals to survive. This state of affairs will be detrimental to private hospitals and private medical schemes. Medical schemes are already looking at ways to re position themselves with top up products for those who will be able to afford it as their market segment will decline.

No problem. Government will now negotiate Service Level Agreements and packages with private hospitals, on their (governments) terms and conditions. You can read more about that on the ANC website. Private hospitals will maintain their autonomy, but will serve ALL patients in a given catchment area, regardless of income. The NHI makes it clear that everyone will be treated equal and threatens to penalize hospitals giving preference based on income or social stand. 

Now you do the math. 5 Million taxpayers will be carrying the entire population plus a few million illegal immigrants who will now have access to the same health care facilities a priviledged few million had for years. Private hospitals will be forced to act as “agents” for the state and serve the 40 million who in the past only had access to state hospitals and clinics. Private hospitals will have to provide the capital, maintain their buildings and equipment, remain competitive in the market etc, yet be fully dependent on government contracts. 

That, my friend, is how the health system will be hijacked. The consequences will be that private hospitals will lose interest in investing in South Africa, private doctors and properly trained nurses will (again) leave en masse. What I’m concerned about is what type of medical services I can anticipate ten years from now, when I may really need it...


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## Halo (May 8, 2008)

Easy: Try and make sure you're not there.


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## vegasboy (Apr 28, 2010)

Halo said:


> Easy: Try and make sure you're not there.


Hehe, that sums it up in a nutshell, Halo. I 'm hoping to encourage healthy debate so I can solve some issues I'm struggling with. We have all been through the bla bla of this is a stunning country (it's the best, yes!) and that crime happens all over the world, and that health reform is a mess in the US etc. etc.

I'm an extremely positive purpose driven person and my whole life revolves around being a turn around agent to assist people to be positive about whatever their circumstances may be. But I'm also a forward thinker and visionary, and as much as I try to see light at the end of the tunnel, everything shows toward the contrary. It frustrates me that other citizens don't seem to see what I believe I am seeing, like the future of health services in this country. Then again, vision by definition is seeing what others don't see and doing what others have not yet done, with reference to those citizens who frustrate me.

So far I have come to the following conclusion: Migration has been part of this world since creation. The Wikipedia definition of migration and especially the reasons set out there for migration (I think it was in our Gr 2 syllabus), gives a lot of insight. The wiki definition makes me feel less guilty for not being as sold out about the future here as many wonderful (naive or just different and content) South African citizens are.

It's not just the crime factor, but socio economic issues which obviously result in crime, that worries me. To my understanding, and I am SO open to debate this so I can have a balanced view, I cannot understand how any parent cannot have the urge to expose their children to options outside of this country, to at least help them broaden their vision and leave the ultimate choice to them. 

To some, especially many professional and wonderful people immigrating here from other African countries, THIS is the land of milk and honey, and will be for generations to come, and rightfully so. I have at least 10 professional friends who are teachers, lecturers at Universities here and more, all from Africa, and they love it. From where they come, this is progress and growth, and I just love seeing them so happy, excited and positive. If you understand the principle of migration you will understand why they are happy to be here and I am not.

But to each its own. A friend of mine one day told me to stop convincing everyone to move on. We need those who are positive to stay and make a difference too. But we should not criticize those (like myself) who have come to the shocking realisation that the country they believed was their homeland, was nothing more than Egypt and that it is time to move to the promised land. 

BTW, the Israelites spent about 430 years in captivity. For many generations it was their homeland. They resisted moving and even wished they could move back. Today they know it was never meant to be their descendants’ homeland. So THAT generation had to make the move, regardless of the resistance and criticism, THAT generation had to became the tipping point. Imagine what would have happened if they just stayed.

Jan van Riebeeck arrived in the Cape 358 years ago... what will happen to our descendants if we all just stay? Who decides when the tipping point has arrived?


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## Halo (May 8, 2008)

This is the tipping point.... ANC rule in 1994
You can debate this till you are blue in the face but there are some certainties which I will list below. The only thing that we must remember is that South Africa is an anomaly (Zim was similar but they then migrated south) in Africa as a nation was born. Unlike many other countries whose population held foreign passports South Africa became a nation and the (crappy) SA passport was born. This was the beginning of the end as this lead to people being stuck and forcing them to make it their home. This will slow the inevitable decay but this is also good for the local Africa population as it will pull them beyond all other African colonies in the coming years.

Certainties:
As the 45-65 group start retiring the decline will speed up as they keep the country ticking over
Cape Town will still be good for a while. (Good is relative to South Africa)
SA will end up like Nigeria in 20-30 years with multinationals taking the resources leaving a rich top layer of corrupt officials and a majority of people who live just above the poverty line.
What will happen to the boers – Perhaps they will take their ox wagon and move to place to Guam?


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## vegasboy (Apr 28, 2010)

Agreed. That's more or less how it will play out. They recently had a name change, now called Guahan which means "we have". Not a bad idea to move there considered they still fall under US rule. We can easily outnumber their entire population and alter the name to "Now WE have"


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## vegasboy (Apr 28, 2010)

I’m just going to deal with one of your (Rooster's) courageous statements you present as fact on this forum (another thread on this forum dealing with South Africa after the world cup: 

Health care is NOT free! You are charged on a scale of income. If you receive a government pension or disability, you will obviously not pay, conditionally that you have no other funds or income of any sort. You have to confirm that when admitted. I work with hospitals and clinics and the Department of Health on SMS level on a daily basis. It is a disaster!!! 
You may find that a given hospital, like Tygerberg in Cape Town, having outstanding Oncology and Cardiology units, the rest is horrific. When we refer patients to some hospitals, they have to take their own linen and food. I have personally witnessed a mental health patient die in his wheelchair after waiting to be seen for many hours. They didn’t even notice that he was dead. When the caregiver alerted them, they just pushed his wheelchair into a corner to attend to later. That’s just one incident of many. I have witnessed many of our mental health patients die of basic physical illnesses, simply because the basic health treatment was not available.

On numerous occasions, we refer patients from our clinic to state hospitals waiting right through the night until the next day to be seen by a medical professional. 

Things are so bad in the Western Cape –still one of the best provinces-, that we had to open our own mental health clinic years ago, working with a few hundred patients, mostly in the no income group. Disaster after disaster working with the DoH, trust me. If we don’t constantly stay on their case, challenge them in parliament, threaten to close our facilities which we are running on one third of MACPP (MINIMUM Accepted Cost Per Person) and more, the health system will crash. I KNOW IT, BECAUSE I HAVE SLEEPLESS NIGHTS ABOUT IT.

In the Eastern Cape, things are worse. We had to take the Department of Health to court a number of times (it was on Carte Blanche), won all the court cases, and still they didn’t give a damn.

Rooster, I am glad your relatives had a positive experience, something that should be noted, but you cannot make unsubstantiated, unproven, unsupported, speculative and questionable claims and post it here without factual evidence.


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## Therooster (Jul 1, 2010)

vegasboy said:


> I’m just going to deal with one of your (Rooster's) courageous statements you present as fact on this forum (another thread on this forum dealing with South Africa after the world cup:
> 
> Health care is NOT free! You are charged on a scale of income. If you receive a government pension or disability, you will obviously not pay, conditionally that you have no other funds or income of any sort. You have to confirm that when admitted. I work with hospitals and clinics and the Department of Health on SMS level on a daily basis. It is a disaster!!!
> You may find that a given hospital, like Tygerberg in Cape Town, having outstanding Oncology and Cardiology units, the rest is horrific. When we refer patients to some hospitals, they have to take their own linen and food. I have personally witnessed a mental health patient die in his wheelchair after waiting to be seen for many hours. They didn’t even notice that he was dead. When the caregiver alerted them, they just pushed his wheelchair into a corner to attend to later. That’s just one incident of many. I have witnessed many of our mental health patients die of basic physical illnesses, simply because the basic health treatment was not available.
> ...


Wrong, it's free.


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## Halo (May 8, 2008)

Nothing is free......

Physicians per 1,000 people (most recent) by country
Decent stats... but seeing its all good, South Africa is most likely now in the top 10  - Due to the new -

1. Doctors that have been trained &
2. the Doctors have immigrated to SA in the last 7 years

Rooster: I think you have no idea about public hospitals in the UK (where my children were born) or ones in Australia where a broken arm was set. You talk and talk but I feel that very few believe what comes out your mouth.


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## Daxk (Jan 20, 2008)

Therooster said:


> Wrong, it's free.



Prove it.


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## Therooster (Jul 1, 2010)

Daxk said:


> Prove it.


Neither my gran , grandfather, or aunt had to pay anything for their medical care. That included a hip replacement, heart bi-pass and operation to clear a blockage between the pancreas and liver. Not even 1 rand. All were in favourable (compared to most) financial positions.

Government medical treatment is free.


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## Daxk (Jan 20, 2008)

Therooster said:


> Neither my gran , grandfather, or aunt had to pay anything for their medical care. That included a hip replacement, heart bi-pass and operation to clear a blockage between the pancreas and liver. Not even 1 rand. All were in favourable (compared to most) financial positions.
> 
> Government medical treatment is free.


I would bet that all three were registered OAPs.
And if someone did not bother to check on their Financials, it would be.

You are saying that someone earning 15k a month gets free treatment in a Govt Hospital?


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## Halo (May 8, 2008)

You have a brave family...

If I go to a state hospital, will I have to pay?
Yes. The amount will depend on how much you earn and on how many dependants you have, according to the hospital rating scale.

At the low end of the scale - that is, if you are unemployed - you will be expected to pay R39 as an outpatient. This will cover your consultation, medication and possible blood or other tests. A pensioner will pay only R13 for the same service. If you are unemployed and need to be admitted, you will pay R194 for up to 30 days.

The maximum a state hospital will charge, if you're at the top end of the income scale, is R55 for a consultation. However, you will be charged additional amounts for medication and tests. For a stay in hospital, a top-end patient (including those on medical aid) will pay R484.90 per day, excluding medicine and theatre costs.

The government is trying to guide patients away from hospitals to its public clinics and community health care centres - where free primary health care services are available. However, patients on medical aids will be charged.
(Source - http://www.southafrica.info/services/health/healthfaq.htm )


Shocking state hospital conditions, South Africa
I would hate to see some of the others.

It does not take long to find out how BAD the public hospital system is.....
http://www.mg.co.za/article/2009-05-24-sa-state-hospitals-in-crisis
_(The World Health Organisation recommended an average ratio of eight doctors to every 10 000 people -- about three times more doctors than South Africa currently has.)_


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## vegasboy (Apr 28, 2010)

Halo said:


> You have a brave family...
> 
> If I go to a state hospital, will I have to pay?
> Yes. The amount will depend on how much you earn and on how many dependants you have, according to the hospital rating scale.
> ...


 Thanks Halo Rooster is either applying reverse psychology or totally and utterly misguided. My concern is that people use information posted here to make life changing decisions.:ranger: I


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## Halo (May 8, 2008)

vegasboy said:


> Thanks Halo Rooster is either applying reverse psychology or totally and utterly misguided. My concern is that people use information posted here to make life changing decisions.:ranger: I


*Every little helps....* as its important for people to get the facts. IMHO, people like Rooster just plain lie, twist statistics and pick those that suit and when faced with a direct question - Duck and dive. 

What their agenda is? - The good Lord only knows.


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## Halo (May 8, 2008)

No Rooster?


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## vegasboy (Apr 28, 2010)

Rooster [ˈruːstə]: A person regarded as cocky or pugnacious [pʌgˈneɪʃəs]adj, readily disposed to fight; belligerent: Inclined or eager to fight; hostile or aggressive.


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## vegasboy (Apr 28, 2010)

In a recent statement of the COSATU Central Executive Committee, 23-25 August 2010 they demand the immediate introduction of the new NHI: 

"We are mobilising for the immediate introduction of the NHI. We shall join forces with civil society and alliance to demand addressing of the current two-tier health system - one for the rich and the powerful who enjoy first class services in the private clinics and hospitals and the other for the overwhelming majority who must face the humiliating third-coach conditions in the public hospitals."

What they are demanding, is that the private hospitals which currently service 7 million of the population, be forced through the mechanisms of the NHI to serve at least "some"  of the remaining 43 million who dispise state hospitals for obvious reasons.

Politicsweb - Political hyenas increasingly in control of state ? COSATU CEC - PARTY

"Aaron Motsoaledi, health minister, wants to improve the (health) situation through a new national health insurance system. The details of that scheme remain unclear, but it has been met with scepticism by many in private healthcare who worry that South Africa cannot afford the costs of establishing it – as much as R216bn, according to the research consultancy Econex. The system would probably oblige private hospitals to lend assistance in some form – something which could drag down their standards as they struggle to help a public sector “in disarray”, the Institute of Race Relations warned recently.
South Africa’s striking nurses open door for private healthcare | beyondbrics | FT.com


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## Jason1 (Jun 23, 2009)

The private health care system is just one example of how everything is being plundered and pillaged in South Africa in the name of equality and when there is nothing left they will pull a Robert and blame apartheid


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