New health tarriff guidelines halted



Health Professions Council of SA bows to pressure.

CAPE TOWN: In the face of strong opposition from the private medical industry as well as threats of legal action, and if necessary, mass protest, the Health Professions Council of SA will delay the publication of its controversial tariff guide.

Issued a week ago, the tariff guide sets out the pricing that private doctors, dentists and other specialists should charge for they work they do.

The guide was to have been gazetted on Friday August 17, but this will be delayed until after a meeting hosted by the HPC on the September 3.

The meeting will allow industry stakeholders like the SA Dental Association and the SA Medical Association to make presentations on the tariff guidelines.

Both organisations had fiercely criticised the guides for being out of touch with reality. The Council used the last published tariff guide – published by the Board of Healthcare Funders in 2006 – as its starting point for the new rates. It adjusted the rate by consumer price inflation, which is well below medical inflation. The older guides also did not include codes for hundreds of new procedures.

“The decision was taken by the Council president, who believed that pressing ahead with the tariffs as they are would destabilise the health industry,” says Council spokeswoman Bertha Scheepers.

The decision was welcomed by the health industry. “This [meeting] is what we asked for,” says acting chairman of the South African Medical Association, Mark Sonderup. “The tariff is not being gazetted which means it has no legal standing.”

The tariffs as they stand are completely inadequate, he says. “All we are asking for is an inclusive process that takes into account the arguments we have previously put forward. We don’t think that is unreasonable.”

Setting tariffs and charges is not a straightforward process. “People have this notion that doctors charge a fee and pocket the money. But in reality doctors are SME’s – they employ bookkeepers and receptionists; they buy equipment; they pay insurance, rates and taxes. Those are costs that must be properly accounted for.

“Getting the pricing right is fundamental,” he says. If they had not been heard, he says, health professionals would have resorted to mass action. “This is the way to go in SA in 2012. We would march on the HPC and demand. This is a serious issue – particularly as we move towards NHI.”

While Sonderup believes this is a genuine attempt by the HPC to hear the industry’s concerns, he questions whether setting pricing is the job of the Council – a statutory body charged with regulating the industry. “Is this not the job of the envisaged pricing commission?”

It is however a step in the right direction.

The ‘sword of Damacles’ hanging over the formation of a pricing commission is a 2003 decision handed down by the Competition Commission which prevents any type of tariff setting within the health industry. “It must go down as the worst ruling the competition authorities have ever made,” says Sonderup. “This is what has created the space for anyone to charge any price.”



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