Consumers will be closely watching two issues with a bearing on the household
kitty: the new tax regime for medical scheme contributions that starts on March
1, and the price of medicines.
Many medical scheme members will see a change in their take-home pay as tax
breaks on medical scheme fees are limited to the first R500 of an individual's
monthly contribution. People who fork out money for medical expenses not covered
by medical schemes will also see changes. They currently get tax relief for
bills topping 5% of their annual income from March 1 the threshold rises to
7,5%.
In the wake of a protracted legal battle with pharmacists, government is
renegotiating the markups permitted on medicine sales.
Meantime, patients will pay different prices for medicines depending on where
they bought them.
Observers say a new dispensing fee is unlikely before mid-year.
Medical schemes and their administrators will be closely monitoring drug
costs, which make up a significant portion of members' bills, but they will be
paying equally keen attention to the implementation of the Government Employees
Medical Scheme (GEMS).
GEMS is expected to drive consolidation in the industry as civil servants
migrate from their current schemes. Unions representing civil servants will
continue negotiating with government on the fine details of GEMS'
implementation, hoping to stave off mandatory membership until the concept has
proved to be value for money for civil servants.
The most far-reaching industry talks will centre on negotiations for the new
health-care charter. Businesses were highly critical of the initial approach to
the charter last year, as they felt sidelined.
This year the team of experts initially handpicked by Health Minister Manto
Tshabalala-Msimang to devise the charter's first draft will take a back seat and
a new group of industry-nominated experts will be talking to government about
how to devise a blueprint for reshaping the healthcare landscape so that blacks
play a greater role in running its businesses and more people get quality
healthcare.
Number one killer HIV/AIDS will take a fair share of headlines. Doctors and
AIDS activists are already on a collision course with entrepreneur Matthias Rath
over his anti-AIDS drug campaign and controversial vitamin-based therapies, and
have drawn the health minister into their legal challenge to his activities.
Rath is set for a litigious year as lawyers gear up to tackle the raft of
legal proceedings he has in turn instituted against media organisations,
journalists and politicians for alleged defamation.
Government is expected to come under renewed pressure to improve the
provision of AIDS drugs at its clinics and hospitals.
As the numbers of patients on antiretroviral therapy rises, experts expect to
see more people battling dangerous side-effects or developing resistance to the
drugs cocktail provided by government as first-line therapy.
This means more patients will need to switch to more expensive drugs and
patient advocates will increase pressure on government to start providing newer
drugs with fewer side effects.
Top of the health department's to-do list is finalising and implementing a
human resources strategy. Without a plan to recruit and retain adequate numbers
of doctors, nurses and other such professionals, the backbone of health-care
services will continue to erode as staff emigrate for better jobs.
The department has little policy work to do in 2006 but has many laws to
finalise or put into effect.
These include implementing the Nursing Bill once President Thabo Mbeki has
signed it into law, tightening legislation controlling tobacco and alcohol,
finalising regulations for traditional and complementary medicines, and
imple-menting the most controversial aspects of the National Health Act.
Doctors and private hospitals are awaiting the regulations spelling out how
government plans to introduce the certificate of need -- a new
system designed to control the location of doctors and hospitals.
The deadly H5N1 strain of bird flu made its way from Asia to Europe towards
the end of last year, catapulting the threat of pandemic human flu to the top of
the international medical agenda.
As 2006 gets under way, experts say SA cannot afford to focus all its
attention on immediate health-care needs at the expense of planning its response
to a possible global flu epidemic that could kill millions of people within a
matter of weeks.
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