Private Healthcare Australia’s Post

Should Healthcare be a Business, or a Human Right? Steve Jobs on his dying bed acknowledged the value of a healthy life. Yet, for many, good health care is elusive because they just can’t afford it. This is mainly due to unscrupulous practices such as the exorbitant charges by many in the medical fraternity. Citizens are caught in a vice-grip, squeezed between unregulated medical costs vis-à-vis fixed prescribed minimum benefits from medical aid companies and neither the twain shall meet. Increasingly, members are forced to take additional ‘gap cover’ or resort to alternative means to fund the shortfall of the ‘out of scheme’ charges. And with citizens already in financial dire straits, this system is wholly unsustainable! Health care should be a basic human right. It should be underpinned in the first instance by the Hippocratic oath, and secondly, by a financial model that makes it affordable. Every professional healthcare practitioner is entitled to fair compensation, and scarce skills do attract a higher tariff. However, a new tariff model is in dire need, to benefit both patients as well as medical aid companies. It is still unclear whether the National Health Insurance Act might be the answer to accessible and affordable health care. But what is clear is that with the crumbling public health system and the unaffordable private health system, the biggest losers are the citizens.  In a country like South Africa that espouses the African humanist philosophy of ‘ubuntu’ (the interconnectedness of people) and ‘Batho Pele’ (people first), the well-being of patients must be prioritised. Patients in their most dire hour of need require compassion and compassion cannot be quantified and reduced to rands and cents.  

Findings from a recent survey highlight the fact that rising healthcare costs are negatively impacting access to care as well as physical and mental health. medZERO offers an affordable solution "The high cost of health care is taking a toll on the health of Americans. More than half of consumers feel stressed when paying their medical bills, and more than 9 in 10 say the stress of these payments has affected their physical and mental health, a recent study from PayMedix found. “A surprising finding from this research is that most American workers with employer-provided health insurance face daunting health care billing and payment problems,” according to the report from the health care payment processing company. “Much of it stems from higher out-of-pocket costs as more employers have had to transition workers into higher-deductible plans to share in increased cost burden of health coverage. These affordability challenges are not only exacerbating a medical debt crisis but they are also causing many Americans to avoid care or disengage with the health care system entirely.”

📣 Just published in Health Affairs Scholar: #UniversalHealthCoverage is a global health priority, one that requires financing strategies that ensure all can access health services without the threat of financial catastrophe. Social health insurance (SHI) schemes may be common, but evidence suggests that the people in low-and middle-income countries are often excluded. In a new commentary, PATH's Muyiwa Tegbe and Saira Nawaz and Johns Hopkins Bloomberg School of Public Health's Kyle Moon offer three recommendations for re-envisioning SHI programs: 🔸 Adopt participatory approaches that inform the design of contributory health insurance schemes. 🔸 Link SHI schemes to other economic empowerment programs. 🔸 Prioritize the needs and preferences of beneficiaries over political expediency. Read more: https://bit.ly/3w4lWTK Project HOPE Oxford University Press

Out of pocket expenditures and catastrophic health spending are major drivers of poverty. We've known this for years. What needs to be explored is what helps with this. Clearly public sector spending hasn't been the answer many would have liked it to be RADS team under Muhammad Ibrahim explored some of the nuances of OOP sand CHE

We, at Research and Development Solutions, have computed the concentration index of households visiting public hospitals using PSLM 2018-19. The findings tell us that poorer households spend are burdened more as compared to richer households. The findings are consistent in out of pocket expenditure share of non-food expenditure (top right graph), catastrophic health expenditure at 10 percent (bottom left) and catastrophic health expenditure at 40 percent (bottom right). While if we see out of pocket expenditure (top left), the graph tells us that higher expenditures burden goes to richer section because they have the capacity to pay, indicating that poor might not avail Healthcare from public hospitals due to higher expenses. The existing structure of subsidizing public sector is not enough, health insurance programs should remain part of the system, where at least poorer segments are properly covered if economic conditions don't allow to cover all. Now that subsidies are being taken back, which were in place for medicines, this problem has further exacerbated. Timely policy shift is crucial for sustaining health conditions of poor segment. Awareness campaigns should be there for the households to utilize health insurance. #healthcaresystems #healthinsurance #catastrophichealthexpenditure #evidencebasedpolicy #HumanDevelopment #healthinequality

High healthcare costs, and the higher insurance premiums that follow, might be bad news in more ways than the obvious: A new study from the National Bureau of Economic Research suggests that, by making it harder for employers to afford coverage, they dampen hiring and cause fulltime jobs to be converted into part-time. The study showed that every 10% increase in health insurance costs reduces the chances of being employed by 1.6% and cuts the number of hours worked by 1%. Put another way, a 1% increase in health care prices lowers an employer’s headcount by about 0.4%. That’s more reason to fight rising healthcare costs. See Axios Vitals’ take below. https://lnkd.in/evR69Hj4

📣 Just published -- a new commentary about the importance of making social health insurance (SHI) schemes work for people and communities in low-and middle-income countries (LMICs).     #Universalhealthcoverage is a global health priority, one that requires financing strategies that ensure all can access health services without the threat of financial catastrophe. SHI schemes may be common but evidence suggests that the people in LMICs are often excluded from such schemes.        In this commentary, PATH’s Muyiwa Tegbe and Saira Nawaz and Kyle Moon from Johns Hopkins Bloomberg School of Public Health offer three recommendations for re-envisioning SHI schemes:     🌍 Adopt participatory approaches that inform the design of #SHI schemes   🔗 Link SHI schemes to other economic empowerment programs  🤝Integrate public feedback to ensure community preferences are built into policy design     https://lnkd.in/gwdwYzRV

"a 1% increase in healthcare prices lowers an employer's headcount by about 0.4%". Maybe, just maybe, we should uncouple health insurance from employment...and start reducing the administrative bloat in our industry. #healthcare #healthinsurance #healthplans #medicaldebt #patientexperience https://lnkd.in/ggEkaWNm

Transforming Health System: Lessons from Egypt’s Integrated Modular Approach That Attracted $50 million Support from World Bank Group - Bright Chimezie Irem As a health policy development expert & health system analyst, examining Egypt’s approach to healthcare reform offers valuable insights for African countries looking to restructure their health systems. Egypt’s recent initiatives and reforms in light of the financial support from the World Bank, provide a model for comprehensive health system transformation. Egypt’s health system has undergone significant changes, particularly with the introduction of a new health insurance law in 2018. This law represents a major shift in Egypt’s approach to health policy, moving away from a system primarily funded by the public treasury to one more reliant on middle-class contributions. This transition aims to improve public health services while maintaining the state’s social role in supporting disadvantaged groups. The law also seeks to transform the Health Insurance Authority into an entity that collects contributions and contracts with both public and private hospitals for service provision. This change was necessitated by financial crises that Egypt faced, leading to the adoption of economic liberalization policies supported by the International Monetary Fund (IMF) and the World Bank. The aim was to reduce the budget deficit and ultimately improve the economic conditions that are closely tied to the health sector. Egypt’s experience is particularly relevant for African countries, as it showcases the transition from a system heavily reliant on public funding to a more sustainable model. The focus on middle-class contributions is a key aspect that African nations could consider, especially in contexts where public funding is limited. Furthermore, the World Bank’s support to Egypt, including a $50 million project announced in 2020, is aimed at transforming healthcare and promoting economic recovery. This financial aid is not just about injecting funds but also about supporting structural changes within the healthcare system. The project focuses on improving public healthcare, expanding family planning services, and supporting Egypt’s new Universal Health Insurance System. The Egyptian model demonstrates the importance of strategic policy changes, fiscal responsibility, and international collaboration in health system reform. African countries can learn from this model by adapting these strategies to their unique contexts, focusing on sustainable funding mechanisms, & seeking international partnerships to support their health system transformations. The Egypt's approach highlights how strategic policy reform, coupled with international support, can lead to significant improvements in healthcare systems. African nations looking to restructure their health systems can draw valuable lessons from Egypt’s experience, adapting these strategies to fit their unique challenges & opportunities. #HealthSystem

Are you struggling to provide affordable healthcare to all of your employees? This can be even more challenging if you have a large population of lower income employees. Industries like #construction, #hospitality, #healthcare often struggle to provide affordable options for their entire employee population. The traditional health insurance markets continue to shrink. However there is a tremendous amount of technology in the health care space to help your employees gain access to care and manage chronic conditions. Price transparency is creating more opportunities for direct contracting arrangements that are quickly growing in popularity. This article from MercerMarsh Benefits addresses the #benefits income paradox, https://bit.ly/4bmdQ86 we explain and highlight how employees who would gain the most from #healthcare benefits are the ones least likely to have access, and what employers need to start doing to support vulnerable groups in their workforce. #employeebenefits #hr #wellbeing