S.Africa: VERY BAD – Communism: Government comes after NHI – National Health AGAIN – Govt publishes pre-NHI price-control plans
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Organisation has submitted formal objections to the ‘Draft Interim Block Exemption for Tariffs Determination in the Healthcare Sector’
Government publishes ‘pre-NHI’ price-control plans
3 April 2025
With its new draft regulations aimed at medical price-fixing, the government hopes to "transition smoothly into the NHI framework."
These regulations establish government price-control over healthcare providers, pushing practitioners to accept set tariffs regardless of expertise or special circumstances.
These restrictions would strip healthcare practitioners of their autonomy, pushing many healthcare professionals overseas or out of the sector – further reducing service delivery.
Sakeliga has submitted formal objections to the ‘Draft Interim Block Exemption for Tariffs Determination in the Healthcare Sector’, published in February by the minister of trade and industry.
Styled as an exemption from the Competition Act allowing the collective determination of healthcare tariffs, the draft regulations actually intend an unauthorised government-led tariff control scheme for healthcare providers, as a way to "transition smoothly into the NHI framework."
While healthcare tariffs for the private health sector have long been determined through bilateral negotiations between providers of healthcare and funders of healthcare, the draft regulations purport to exempt medical aids, healthcare providers and others from provisions of the Competition Act that prohibit collective, as opposed to just bilateral, tariff determinations.
Lifting restrictions on collective price determination is in and of itself not problematic.
However, the “exemption” goes much further:
It mandates that the Department of Health will exercise substantial control and even have the final say on the determination of maximum tariffs for health services. These maximum tariffs will relate to Prescribed Minimum Benefits and non-Prescribed Minimum Benefits.
Once determined, the maximum tariffs will operate to the preclusion of bilateral agreements that might be more favourable to healthcare providers.
While claiming to make healthcare more affordable, the draft regulations would actually give government officials a controlling say on how much doctors can charge for private services.
Healthcare providers would be effectively precluded from negotiating better rates, even when justified by their expertise or special circumstances.
The draft regulations are thus not an exemption, but an unlawful attempt at a government-led price control scheme in preparation for NHI implementation.
Above all, the draft regulations, if promulgated, will lead to fewer providers, degraded service quality and diminished rural access in the private sector, and increased pressure on the already strained public sector.
When the government effectively caps what healthcare providers can charge, those who can’t cover their costs or are faced with unacceptably low yields, will be forced to close their practices, cut corners on patient care, or leave the industry or country entirely.
Rural communities and specialised services would be hit hardest, as these often have higher operating costs. Patients may face longer waiting times, fewer healthcare options, and declining quality of care, all while the government prepares the ground for its NHI scheme.
Sakeliga’s position is that the draft regulations are so flawed that they require complete withdrawal.
We intend to oppose its implementation, just as we intend to oppose the implementation of the NHI Act.
Read Sakeliga’s submissions here.
Issued by Sakeliga, 3 April 2025
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