Proposed Medical Aid Societies Regulatory Bill biased

Proposed Medical Aid Societies Regulatory Bill biased

Staff Writer

ONE of the county’s largest medical aid services provider CIMAS says the proposed Medical Aid Societies Regulatory Bill entrenches conflict of interest instead of eliminating it as it seeks to protect only the healthcare providers and consumers and not the industry

In 2017, the Minister of Health and Childcare (the Ministry) circulated a draft a bill to establish the Medical Aid Societies Regulatory Authority and also to amend the Medical Services Act.

CIMAS CE  Vulindhela Ndlovu last week told a  Journalist Mentoring Program that  the proposed authority does not take into consideration the interest of MAS(medical aid societies) but instead that of service providers (healthcare practitioners and members to some extent) while international best practice dictates that industries must self-regulate.

“There is a conflict of interest and the fear that members will be directed to those facilities. In our view the conflict of interest is “perceived”.  Legislation limits what MAS can do with the facilities,
for example, directing of members to MAS facilities is deemed anti-competitive in terms of  the Competition Act [Chapter 14:28]. The Medical Societies Regulations themselves prohibit directing and therefore there is no conflict of interest,” he said.

He added that the move by to ban service provision by MAS in CIMAS’ view is a restrictive practice as it is exclusionary and restricts the distribution of a service while also limiting the facilities available for the distribution of any service, in this instance healthcare services

Ndlovu said the purpose of the bill should not be to “REIGN IN” on medical aid societies but to instead proffer a platform for enhancing service delivery to members through the MAS through private public partnerships (PPPs).

“The main role of the health ombudsman or complaints commission is to receive and assess complaints relating to health service providers and resolve or assist in the resolution of complaints against MAS. This is critical in an environment where the health sector has deteriorated, and patients and MAS have no recourse to an independent complaints handling procedure,” he said.