The act is intended to consolidate the laws relating to registered medical schemes; to provide for the establishment of the Council for Medical Schemes as a juristic person; to provide for the appointment of the Registrar of Medical Schemes; to make provision for the registration and control of certain activities of medical schemes; to protect the interests of members of medical schemes; to provide for measures for the coordination of medical schemes; and to provide for incidental matters.
Resource allocation and health financing
South Africa: Medical Schemes Act 131 of 1998
GROUP PREMIUMS IN MICRO HEALTH INSURANCE EXPERIENCES FROM TANZANIA
Kiwara AD: East African Journal of Public Health 4(1): 28-32, 2007
A comparative approach was adopted to study four groups of informal economy operators (cobblers, welders, carpenters, small scale market retailers) focusing on a method of prepayment which could help them access health care services. Two groups with a total of 714 operators were organized to prepay for health care services through a group premium, while the other two groups with a total of 702 operators prepaid through individual premium, each operator paying from his or her sources. Data collected showed that the four groups were similar in many respects. These similarities included levels of education, housing, and social services such as water supplies, health problems, family size and health seeking behaviour. At the end of a period of three years 76% of the members from the two groups who chose group premium payment were still members of the prepayment health scheme and were receiving health care. For the two groups which opted for individual premium payment only 15% of their members were still receiving health care services at the end of three years.
Lost to follow up – Contributing factors and challenges in South African patients on antiretroviral therapy
Maskew M, MacPhail P, Menezez C, D Rubel D: South African Medical Journal 97 (9) : 853-857, 2007
This study highlighted financial difficulty as the major obstacle to obtaining treatment in one province of South Africa. There is evidence in support of providing ARV treatment free of charge to HIV positive patients who qualify, as occurs in other provinces in South Africa. It is also suggested that providing ARV therapy at more local clinics in the community would make treatment more accessible. Provision of several months' supply of medicines per visit would help to reduce transport costs and minimise patient expenditure. These interventions may reduce the incidence of patients lost to follow-up in this community.
Medical schemes council is aware of flaws in equalisation fund data
du Preez L: Personal Finance, 8 September 2007
A number of different methodologies will be tested as part of the Risk Equalisation Fund (REF) shadow process in South Africa, according to the Registrar of Medical Schemes Patrick Masobe, under whose control the shadow process falls. The REF is being set up to make sure that all medical scheme members, regardless of their age or state of health, pay the same to access certain basic healthcare benefits. Medical schemes that have a large number of younger and healthier members will have to pay into the REF, while schemes with many older and sicker members will receive payments from the fund.
Models for funding and coordinating community-level responses to HIV/AIDS
Birdsall K, Ntlabati P, Kelly K, Banati P: Centre for AIDS Development, Research and Evaluation, South Africa, 2007
This research report examines how community organisations responding to HIV can be effectively supported. The report uses case studies to illustrate seven different models for supporting community organisations through a combination of funding, capacity building and networking. These models show the importance of tailoring funding and support according to an organisation’s needs, size and stage of development. These case studies also highlight the importance of providing multi-year funding to allow organisations to grow and the usefulness of horizontal learning and networking. Each of the models have the potential to be replicated or scaled-up.
Poverty Reduction Budget Support (PRBS) in Zambia Joint Annual Review 2007: Learning assessment
Gerster R, Chikwekwe M: Southern African Regional Poverty Network (SARPN), 13 July 2007
Mandated jointly by the Government of the Republic of Zambia (GRZ) and the Cooperating Partners (CPs) committed to Poverty Reduction Budget Support (PRBS), the learning assessment (LA), integrated into the Joint Annual Review (JAR) 2007 process, pursued the overall objective of developing practical recommendations on strengthening the effectiveness and efficiency of PRBS-supported programme implementation. The recommendations are based on PRBS experience in general and the 2007 JAR process in particular. The quality of dialogue, performance and accountability was to be specifically assessed. Methodologically, the LA made use of good practices developed elsewhere, observations of JAR sessions, interviews, and written feedback.
The macroeconomic consequences of financing health insurance
Deloach DB, Platania JM: Social Science Research Network (SSRN), 23 August 2007
Employer-financed health insurance systems, like those used in the United States, distort firms labor demand and adversely affect the economy. Since such costs vary with employment rather than hours worked, firms have an incentive to increase output by increasing worker hours rather than employment. This paper constructs a heterogeneous agent general equilibrium model where individuals differ with respect to their productivity and employment opportunities. The authors generate steady state results for several alternative models for financing health insurance: one in which health insurance is financed primarily through employer contributions that vary with employment; a second where insurance is funded through a non distortionary, lump-sum tax; and a third where insurance is funded by a payroll tax. They further measure the effects of each of the alternatives on output, employment, hours worked and inequality. These findings can be compared with East and Southern African communities that employ such employer-financed health insurance systems.
Emergency plans needed to bridge health financing gap
Richards T: World AIDS Campaign, 12 July 2007
The World Health Assembly has in the past three years passed several resolutions on health financing and health worker shortages - yet there has been an overall increase in annual African deaths resulting from lack of sustainable health finance and health worker shortages. The worlds Health Ministers must now move from passing resolutions to effecting resolutions and emergency action to end the deaths of over 8 million Africans a year from preventable and treatable diseases.
Equity in health care in Namibia: Developing a needs-based resource allocation formula using principal components analysis
Zere E, Mandlhate C, Mbeeli T , et al, International Journal for Equity in Health 2007, 6:3, 29 March 2007
The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism. Principal components analysis was employed to compute asset indices from asset based and health-related variables, using data from the Namibia demographic and health survey of 2000. The asset indices then formed the basis of proposals for regional weights for establishing a needs-based resource allocation formula.
New Zambian SADC leadership must make 15% health pledge priority
Africa15percentcampaign, 21 August 2007
The Africa Public Health Rights Alliance “15% Now!” Campaign has called on the new Chair of SADC President Levy Patrick Mwanawasa to make it a priority of his term of office to ensure that alongside upholding Democracy and Good Governance, all SADC countries emulate the leadership of Botswana and meet the Abuja African Union pledge to allocate at least 15% of national budgets to health. President Mwanawasa assumed SADC leadership at the end of the last summit that ended on the 17th of August. In a statement issued in Lusaka, the Campaigns coordinator Rotimi Sankore stated:“SADC leaders must realise that they have no choice but to follow the lead of Botswana in meeting the Abuja 15% pledge. Its really a choice between meeting the 15% commitment now, or presiding over mass burials of citizens between now and 2015 when they should have met the health based Millennium Development Goals”.