In the new national health system, power could shift from hospitals and into the hands of patients.
This is the view of leading Harvard professor and international health insurance expert Bill Hsiao, who told a seminar in East London last week that in the envisioned National Health Insurance (NHI) “money will follow the patient”.
The seminar, hosted by the University of Fort Hare’s Albertina Sisulu executive leadership programme in health, looked at how to strengthen health systems in preparation for the implementation of the NHI.
Hsiao, a professor of economics leading a new programme in health systems studies at Harvard, was among the guest speakers at the one-day seminar at the International Convention Centre.
By international standards, Hsiao said South Africa suffered from a mis-allocation of resources, poor management and inefficiency of public health services due to patronage and corruption, poor leadership and management and inefficient bureaucratic practices.
He said the NHI would change this and force organisations to be on their toes, to be innovative and flexible to patients’ needs and values.
Hsiao said public health facilities which received a direct budget from government were likely to play to the tune of where the money came from as opposed to being more patient-centric.
The NHI, on the other hand, would force facilities to prioritise patients.
Further benefits of the NHI would be experienced by hospital CEOs and health facility managers, whose budgets would come from taxes designated for health instead of being determined directly by government based on priority.
“This means hospital CEOs will see their health budget stabilise,” he said.
He said the money would come from patients accessing services at facilities.
“If the patient does not like your service, they leave with their money. It’s a way to force public organisations to pay attention to the people they are serving,” he said.
Hsiao said this would create competition between facilities and help them meet quality standards.
“The NHI is a major transformation. It affects all healthcare workers and all patients. Now the patient has the power.
“Usually, as observed across the world, transformation will take 20 years or more because people have to change, quality has to change, systems have to change,” he said.
Hsiao has been active in designing health system reforms and universal health insurance programmes for America, China, Poland, Columbia, Taiwan, Vietnam, Hong Kong, Sweden, Cyprus, Uganda and now South Africa.
He said the various health departments had the basic layer of quality in as far as their national core standards were concerned, where cleanliness and drug supply were highlighted as priorities, among others.
“But patients want more than that, they want a guarantee the doctor at that facility will make them well. Your national core standards have not defined that,” he said.
Hsiao urged government to give hospital CEO and directors of public health facilities the power they need to take responsibility for the transformation.
He said this power had to be in the form of financial, human resources, capital investment and administrative muscle.
Hsiao believed South Africa was on the right track. — vuyiswav@dispatch.co.za
Patients to call shots in new SA health deal
This is the view of leading Harvard professor and international health insurance expert Bill Hsiao, who told a seminar in East London last week that in the envisioned National Health Insurance (NHI) “money will follow the patient”.
The seminar, hosted by the University of Fort Hare’s Albertina Sisulu executive leadership programme in health, looked at how to strengthen health systems in preparation for the implementation of the NHI.
Hsiao, a professor of economics leading a new programme in health systems studies at Harvard, was among the guest speakers at the one-day seminar at the International Convention Centre.
By international standards, Hsiao said South Africa suffered from a mis-allocation of resources, poor management and inefficiency of public health services due to patronage and corruption, poor leadership and management and inefficient bureaucratic practices.
He said the NHI would change this and force organisations to be on their toes, to be innovative and flexible to patients’ needs and values.
Hsiao said public health facilities which received a direct budget from government were likely to play to the tune of where the money came from as opposed to being more patient-centric.
The NHI, on the other hand, would force facilities to prioritise patients.
Further benefits of the NHI would be experienced by hospital CEOs and health facility managers, whose budgets would come from taxes designated for health instead of being determined directly by government based on priority.
“This means hospital CEOs will see their health budget stabilise,” he said.
He said the money would come from patients accessing services at facilities.
“If the patient does not like your service, they leave with their money. It’s a way to force public organisations to pay attention to the people they are serving,” he said.
Hsiao said this would create competition between facilities and help them meet quality standards.
“The NHI is a major transformation. It affects all healthcare workers and all patients. Now the patient has the power.
“Usually, as observed across the world, transformation will take 20 years or more because people have to change, quality has to change, systems have to change,” he said.
Hsiao has been active in designing health system reforms and universal health insurance programmes for America, China, Poland, Columbia, Taiwan, Vietnam, Hong Kong, Sweden, Cyprus, Uganda and now South Africa.
He said the various health departments had the basic layer of quality in as far as their national core standards were concerned, where cleanliness and drug supply were highlighted as priorities, among others.
“But patients want more than that, they want a guarantee the doctor at that facility will make them well. Your national core standards have not defined that,” he said.
Hsiao urged government to give hospital CEO and directors of public health facilities the power they need to take responsibility for the transformation.
He said this power had to be in the form of financial, human resources, capital investment and administrative muscle.
Hsiao believed South Africa was on the right track. — vuyiswav@dispatch.co.za
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