NEHAWU statement on the release of the Health Market Inquiry Report
30 September 2019
The National Education, Health and Allied Workers’ Union [NEHAWU], today note the release and hand-over of the Health Market Inquiry (HMI) Report of the Competition Commission to government.
As a union campaigning for the transformation of the country’s healthcare system, of which the introduction of the National Health Insurance (NHI) is a key catalyst, we shall find time to study the report carefully. We hope to distill some insights in terms of the structural layout and operations of this otherwise opaque and profiteering industry. We have to hasten to say that the inquiry itself, which was outsourced by the Competition Commission to various parties, some of which had conflict of interests, ironically created some perverse incentive as it dragged on for five years at the great cost to the public.
Notwithstanding the useful information that might be in the body of the report, we find the recommendations being largely outmoded and irrelevant in the new concrete context of the transition to a single-payer, universal health coverage and integrated system unfortunately. At best, to the extent that the report confirmed the existence of an oligopoly of the private hospital groups, anti-competitive practices amongst the private General Practitioners and Specialists, and such profiteering and “market-distorting” practices in the funders’ sector, involving administrators and managed care organisations, we would call for more appropriate interventions in the context of the NHI. In this regard, the remedies of the report have been by-passed by developments.
The report underscores the necessity and urgency of the seamless yet steady phasing-in of the NHI. It’s a pity, that the recommendations of the report are weak and perversely wheeling out elements of the failed Social Health Insurance model. We are vindicated that the private health industry has been found to be inefficient, wasteful, without value for money and no standardized measurement of the quality of care to justifying its claims, and much less its clinical performance in relation to its extorted users. Such are the inherent features of a commodified healthcare system everywhere it is in existence, and in this regard South Africa is reproducing similar grotesque features of high and forever rising costs and relatively poor clinical outcomes manifested in the healthcare system of the United States of America [USA], which is an outlier amongst the Organisation for Economic Co-operation and Development [OECD] countries.