South African patients worse off than European counterparts

An in-depth study by the World Health Organisation and the Organisation for Economic Co-operation and Development shows private hospital and doctor prices here might appear to be equal to those in France and Germany, but South Africans earn less and have a weaker economy.

In addition, South Africans undergoing surgical treatment spend less time in hospital than Europeans. On average, South Africans spend three days in hospital after an operation, while an average stay in European countries is 4.4 days.

Three days was an "exceptionally" short average stay in hospital, said Francesca Colombo, head of healthcare at the OECD.

The study suggested patients were getting poorer quality healthcare and there were attempts by medical aids to control costs, she said.

South Africa was compared to Austria, Czech Republic, Finland, France, Germany, Hungary, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland and countries in the UK. The study shows South Africa's GDP is 26% lower than the average 20 OECD countries' GDP but private health prices are 92% higher.

Private spending on medical aids for 17% of the population equals 41.85% of all South Africans' health expenditure. This is six times the average 6.8% spending on medical aids in other countries.

"This is a very large use of resources for a relatively small share of population," said Colombo.

She said the researchers looked at procedures from 60% of medical aids done between 2011 and 2013.

Hospital prices, specialists and pathology (blood tests) were the big cost drivers, she said.

The study was commissioned by Health Minister Aaron Motsoaledi. It found South African private healthcare to be the most expensive when looking at what South Africans earn and what they pay compared to what Europeans earn and pay for private healthcare.

Results of the study were released yesterday at the Competition Commission inquiry for private healthcare public hearings.

World Health Organisation country representative Sarah Barber said data showed healthcare was "relatively cheap" for the top 10% of South African earners and prices were "unaffordable for the other 90% of South Africans".

Motsoaledi said he had said private healthcare prices were too expensive for years, but was seen as attacking the sector, though he wasn't. He felt vindicated by the report.

The WHO said if specialists were earning so much in private healthcare it was hard for the government to pay them to work for the state. High private prices "spill over" into the public sector and the government can afford fewer doctors.

But the commission's panel found fault with the researchers comparing private healthcare in South Africa to private healthcare in Europe, saying they were fundamentally different.

Private healthcare abroad, said panellist Nthuthuko Bengu, is for cosmetic procedures and extras like private rooms in hospitals.

Bengu called the comparisons "dramatic" as private hospitals were used by all medical aid members in South Africa but were optional in Europe due to their high-quality government hospitals.

Barber said OECD countries had set prices or benchmarks for what each procedure or appointment should cost. But no such mechanism exists here.

Hospital Association president Melanie da Costa criticised the report, saying it looked at affordability of private healthcare for all South Africans, not those on medical aid.

She said it also compared state hospitals abroad with private hospitals in South Africa.

She said a study had to look at affordability of private healthcare for people with jobs rather than affordability of private healthcare for the unemployed, as the study did. She said this was "mischievous".