On December 23, 2016, government gazetted the demarcation regulations, which drew a line in the sand between medical expenses insurance and medical scheme benefits.
This is very important to every consumer of healthcare
Many will be forced to rely on an already over-burdened public sector
The consequences and constitutionality must be understood
join us to understand why critical questions need to be asked and issues
resolved before implementation begins.
- What are our current problems – state and private?
- Is the government’s proposed national health insurance (NHI) policy financially, or even practically, feasible?
- Is the existing medical schemes act (MSA) of 1998 the correct framework to promote and foster the expansion of the private healthcare sector?
- In a free market, what can the private sector deliver right now?
- The regulations:
- show a blatant disregard for ordinary people’s right to access healthcare
- are based on the dubious principle that health insurance products are harmful to the medical schemes industry.
- Consumers who are prohibited from entering into private arrangements with medical insurance companies and who cannot afford medical scheme membership now find themselves forced to rely on an already over-burdened public sector – is this constitutional?
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Michael Settas has worked in the private
healthcare sector for the past 25 years. He is the co-founder (2009) and MD of
health insurance business, Xelus, and is also on the board of the KaeloXelus
group, a provider of health and wellness product solutions to more than half a
million citizens. His main interest has been in understanding healthcare
funding models and the resultant impact on costs, quality and sustainability. He
consulted widely to medical schemes on the technical aspects of benefit design,
pricing, risk management and statistical modelling to better understand the
cost drivers in healthcare.
Patrick Bracher is
a leading director in the banking and finance team of Norton Rose Fulbright based
in Johannesburg. He has years of invaluable experience and a depth of knowledge
in insurance law (pure insurance, regulatory aspects and the commercial side),
financial transactions and regulatory law. His knowledge also embraces related
financial services such as the Financial Advisory and Intermediary Services Act
and the Medical Schemes Act. He advises many of South Africa’s insurers, the
South African Insurance Association, Lloyd’s of London in South Africa, the
National Credit Regulator and the Council for Medical Schemes. Patrick is the
external examiner for the University of South Africa’s post-graduate insurance
courses. His commercial knowledge is supplemented by a wide-ranging knowledge
of the common law; and practical understanding of the law relating to consumers
such as the National Credit Act, Consumer Protection Act, and Protection of
Personal Information Act especially from the suppliers’ point of view.
Patrick is known for his clear opinions,
practical advice and plain language. He edits most of the publications issued
by Norton Rose Fulbright South Africa. He has written countless articles
himself and presented many lectures and seminars. He is a constitutional lawyer
and he hosts a fortnightly radio programme on the Bill of Rights.
He commenced his legal career in the coastal
city of Port Elizabeth, South Africa, straight from high school. While doing
his articles, he simultaneously studied law by correspondence through the
University of South Africa – one of the world’s foremost correspondence
universities. He qualified as an attorney at the age of 22, thereafter gaining
extensive experience in most fields of law. He joined the practice in 1988.
Patrick was listed as an expert in insurance
and reinsurance in Who’s Who Legal, 2016.
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