Some members of the private healthcare sector regard the introduction of National Health Insurance (NHI) a threat, but that should not be the case, says Dr Mangaliso Mahlaba, chief operating officer of Thebe Ya Bophelo Healthcare, South Africa’s foremost black-owned and –managed healthcare administrator.
“There is a huge disparity in the quality of healthcare services offered by the private and public sectors. If the NHI is to succeed in its aim of reducing that disparity, then we have to find ways of putting private-sector expertise to work for the public good,” he argues. “We at Thebe Ya Bophelo Healthcare see huge potential for us, and private healthcare in general, in the rollout of the NHI.”
One of the key contributions that an operator like Thebe Ya Bophelo Healthcare can offer is considerable experience and expertise in administration and management. Dr Mahlaba points out that Thebe Ya Bophelo Healthcare’s aim to provide private health care for lower income groups positions it perfectly to provide the kind of skills needed to manage a broad-based national health insurance scheme and, critically, to manage patient/member relationships at scale – and at a low cost.
“I believe that part of transforming the healthcare landscape in South Africa will be to enable medical professionals to work in both the public and private sectors – something that will require a sophisticated interface, Dr Mahlaba comments. “This is work that the private players like Thebe Ya Bophelo Healthcare have already done.”
Technology will play a pivotal role in all aspects of the proposed NHI. This is an area in which health care administrators again have a lot to offer as they already use technology extensively for a range of functions: back-office administration, interfacing with doctors and other service providers, and managing electronic health records.
“Electronic health records in particular will be essential in providing patients with a high quality of care while reducing costs and saving time,” Dr Mahlaba says. “In any kind of national health system, patients will not have the luxury of being treated by the same professionals, and thus a reliable, comprehensive and readily available patient/ medical history is going to be vital. Implementing such a system is not simple, and administrators like us already have operational systems and processes in place. Collaborating with the private sector will save the state both time and money.”
The private sector, he adds, is also pioneering the use of technology to help manage chronic illnesses. These illnesses account for a massive proportion of any medical scheme’s expenses, and proper management to ensure compliance is a recognised cost-saver with an extremely positive impact on patients’ quality of life.
“Running the national health insurance successfully – which means providing the best care possible within one’s financial constraints – ultimately boils down to how well one manages risk,” Dr Mahlaba concludes. “We as healthcare administrators are adept at risk management, and this is hard-won experience that will really benefit the NHI.”