he Health Market Inquiry (HMI) has given role players in the
private healthcare sector another chance to give their input on the Panel’s
preliminary findings and recommendations. This follows the recent seminars
organised by the HMI that allowed representatives from private hospitals, the
funding industry and healthcare professionals in private practice to engage
with the panel on their differences and agreements with the preliminary
report’s main findings and recommendations released last year.

The three seminars addressed facility- and funder market
concentration and supplier induced demand and overutilisation. The HMI has now
requested stakeholders who presented at the seminars to make submissions
particularly related to the key  questions and differences that were raised
around issues such the data sources that were used, the interpretation and
analysis of the data and factors that were not taken into consideration in the
draft conclusions and recommendations.

At the seminar on supply-induced demand both SAMA and the
three biggest private hospital groups highlighted specific deficiencies in the
data and analytic methods used by the HMI, saying that the wrong countries were
used to compare South Africa’s admission rates against, that the inquiry’s
definition of discretionary procedures was wrong and that important factors
that have led to increased utilisation of healthcare services were not taken
into consideration.

Presenting on behalf of SAMA, Dr Selaelo Mametja said the
association was not convinced that supply-induced demand was demonstrated in
the HMI’s analysis because of:

  • Poorly defined markets
  • No assessment of initial equilibrium conditions in the
    market
  • The inclusion of superfluous variables in models while
    important determinant variables were not included.
  • Adjusting only for age to explain increased admissions while
    other relevant confounding factors were not taken into consideration.

In its presentation, the HMI maintained its findings that
more doctors in specific geographical areas were associated with higher rates of
hospital admission, that more treatment increases doctors’ earnings, that doctors
are in a position to recommend higher than necessary treatment rates and that
there is excess capacity in the private hospital market with hospitals
benefitting from higher admission rates.

However, it conceded that it couldn’t demonstrate that hospitals
can or do directly influence patients to undergo treatment or can influence
doctors to overservice patients using their facilities.

According to the HMI, it agrees that many of the data sources
it used were poor and that it could have caused significant errors and gaps in
its analyses and findings, but emphasised that it was the only data it had
access to.

“In the hospital industry, we asked for better data but were
told that it did not exist, which is interesting in the light of people now saying
that our data are wrong without providing us with a better data source,” the
HMI concluded in its presentation.

Stakeholders who want to make submissions based on the
seminar engagements and debates have until Friday, 26 April to submit it to the
HMI by sending it to EnikaP@compcon.co.za.
The submissions will then be published on the HMI website http://www.compcom.co.za/healthcare-inquiry/
. Stakeholders can also view all updated  presentations made at the seminars on http://www.compcom.co.za/seminar-presentations-2/

According to the HMI’s revised timetable, it will be reviewing
and analysing stakeholder input and request further engagements if deemed
necessary from May to August after which its final findings and recommendations
will be published on 30 September this year.