by Steve Mullholand

Health care for all

Modern medicine remains a luxury in remote areas

Medical care becomes taxing
Modern medicine remains out of reach to some

For over a millenia, those within medicine have been tasked to diagnose illness or damage, regardless of how it was inflicted, and then try to heal.

Even though we are all entitled to medical care, it is seldom available for some, certainly not in its modern form.

It is simply not possible to apply modern medical techniques deep in the jungle or far out on an Indian plain or on a remote mountainside or in a distant Zulu village.

The benefits of modern medicine can practically never be spread evenly. Different societies adapt their own means of trying to supply their citizens with medical treatment.

Obviously, those fortunate or hard working, with the means, simply pay for it, perhaps claiming taxes and some of the outlay against insurance policies which we now know as medical aid schemes.

Such schemes are, by and large, designed so that the young and healthy pick up the costs of the old and sickly. Those who insure their possessions against fire and theft but suffer no misfortune are subsidising those who are victims of such crime and poor fortune.

We are indebted to the Greeks (Hippocrates and the brilliant eye and brain surgeon Galen), Egyptians (Imhotep), Chinese, Sri Lankans (our first clinical hospitals), the celebrated Indian surgeon Sushrata (father of plastic surgery), and many other legends.

Of course, Western contributions have been massive, from the x-ray to insulin, penicillin, blood-clot busters and anaesthetics.

Man has a distinguished history in the fight to improve our lives, to further our years in a decent and satisfying manner. This is something to be proud of, although the fight to extend these benefits to those less fortunate will be an endless and ever-distant goal.

Insurance companies are in reality large and sophisticated casinos. When one takes out an insurance policy, for whatever reason, one is placing a bet which one does not wish to win.

Insurers employ actuaries to figure the odds, much as do the bookies at the race track. The only difference is that when your horse wins at the races the bookie just pays, he doesn't argue, while the insurers often dispute claims.

Among the least avoidable of such bets is that one is going to have an accident, while the insurance company is betting that the insured is not going to have it. That's why safe drivers are rewarded with lower premiums.

All this brings me to an incident at a well-known hospital involving the magnificent sum of R50. The provider of the service, a radiographer, saw fit to add R50 to my account as an 'admin fee' above and beyond their fees for services and not claimable from the medical aid or, it seems, from South African Revenue Service. The South African  Medical Association Private Practice Unit states unequivocally: "Doctors may only charge for professional services rendered by him/herself".

"It is against the ethical rules of the Health Professions Council to charge separate fees.Costs are part of practice overheads, and should therefore be charged as part of the medical service tariff and not as a separate fee. Health professionals must always submit an identical bill to all parties, including patients and medical schemes. A 'split bill' where some charges are omitted from the statement sent to medical schemes, but included on the patient statement is not allowed."

Further, "levies, admin fees and co-payments do not constitute professional medical services and may therefore not be charged," says the unit.

So, folks, tell them to shove their admin fees.


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This edition

Issue 16


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