Patients in the private sector are denied access to free medicines from state "donation" programmes when they have run out of medical funds.
This is according to Campaigning for Cancer chairman and Werksmans lawyer Neil Kirby. Addressing the World Cancer Leaders Summit in Cape Town yesterday, he called for a change in the law to allow patients with medical aids to apply for donated treatment while remaining with their own doctors in private practice.
The state's life-saving programmes run on drugs donated by pharmaceutical companies.
An example of such a programme is Novartis giving away the leukemia drug Glivec to selected government patients since 2002.
THE Competition Commission has received submissions from a range of groups on the draft terms of reference for its proposed market inquiry into the private healthcare sector.
Interested parties had until Tuesday to respond to the draft terms. The commission will — from now until the end of next month — consider the comments received to finalise the document.
The commission expects the final terms of reference to be ready for publication by the latest in the middle of August. The terms of reference set out the scope of the inquiry after the commission identified factors that gave it reason to believe there were features of the private healthcare market that might "prevent, distort or restrict competition".
The eagerly-awaited September government white paper on healthcare reform needs to fill the gaps with much-needed specifics on the planned National Health Insurance Scheme (NHIS) implementation, according to a lawyer on Tuesday.
“Providing universal access is laudable and is a constitutional directive, but we must be certain that we have our eyes fixed on the goal - efficacious and quality healthcare - and not just the promise of it,” says Neil Kirby, director and Health, Pharmaceutical & Life Sciences Practice Area head at Werksmans Attorneys.
The NHI concept is nothing new in larger, wealthier democracies.
“The question is whether such a system is a good fit for South Africa,” says Kirby.
The Obama administration in the US and the South African government appear to be proceeding down similar paths in terms of proposed healthcare reform, though the US progress has been far from smooth.
“The big difference between the US and SA on this is that the American legislation made it mandatory for all US citizens to purchase private health insurance, whereas in South Africa, there is no such obligation to join a medical scheme.”
In essence, Kirby suggests, “the NHIS is basically a large medical scheme - to be governed by a board of trustees in the form of an authority to be created by legislation - and making available only a prescribed set of benefits. These will be provided by a prescribed but legally-accredited set of healthcare providers, including doctors and hospitals for a cost negotiated between the State and the healthcare providers.”
This formula is already in place in the substance of the Government Employees Medical Scheme (GEMS) which, due to its membership and affiliation to the public service.
Kirby describes the present NHIS concept as, ‘the tin man without a heart...it promises access, but access to what?’
The first implementation phase of the NHIS is supposedly set to begin in 2012, and it will make scheme membership compulsory for all South Africans.
Payment for the NHIS will come from a levy or tax deducted from the salaries of formal sector employees, and by the state for the unemployed.