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Caps on what doctors can charge for their services are likely to see many leaving the country, making an already-overburdened healthcare sector even weaker, if the National Health Insurance (NHI) is implemented in its current format.
The Sunday Times reported that analysts have warned that state-regulated fees, envisaged by the NHI, will drive many doctors away from the country.
Once implemented, the system will work like this, according to City Press: patients will go to NHI-accredited doctors and the NHI fund will pay those doctors, in much the same way as private medical aids currently do.
Health Minister Aaron Motsoaledi released the NHI and Medical Schemes Amendments bills last week for comment.
The wide-ranging changes to the healthcare system are supposed to do away with the system currently in place to provide universal, quality healthcare for all. But analysts have said that doctors will be negatively affected by it and, in a country where there are already too few doctors, it is a situation we can ill afford.
According to the Sunday Times, doctors and hospitals that refuse to comply with new capped fees will not be accredited by the NHI.
Neil Kirby, medical lawyer at Werksmans, told the Sunday Times that it was not a good idea to get rid of doctors who did not comply given the scarcity of doctors.
Rapport on Sunday reported that doctors are ready to oppose the fixed tariff provisions in the bill in court.
According to Rapport, around 3,000 doctors who are members of the SA Private Practitioners' Forum will simply refuse to take part in the project. Its CEO, Dr Chris Archer, told Rapport the forum would go to court to oppose any attempt to introduce across-the-board tariffs.
Henru Krüger, operations manager and legal expert at the Alliance of SA Independent Practitioners' Associations (Asaipa), also told Rapport doctors and other medical practitioners would turn to the courts should they be forced to work at fixed rates.
According to the paper, Asaipa represents 14 independent practitioners' organisations comprising more than 1,100 GPs and other health workers.
Norton Rose Fulbright director Michelle Davis told the Sunday Times that doctors were likely to challenge the tariffs in court, as they had challenged price control in court before.
As far back as April 2013, the SA Private Practitioners' Forum had already warned that the NHI would not work. According to City Press, the forum said it was not universal health coverage that was a problem, but the NHI version.
Archer said the NHI should be pioneering an affordable way to improve access to healthcare for the poor instead of doing away with the two-tier (public and private) system currently in place.
On June 8, The Times reported that analysts foresaw an exodus of doctors if the NHI is implemented.
This followed the deadline for responses to the white paper on the NHI, released by the department of health in December. Over 100 submissions were reportedly received by the May 31 deadline.
The SA Private Practitioners' Forum said at the time that government was unable to retain medical staff as it is, and that doctors will go bankrupt if government sets healthcare prices, as the white paper stipulates.
The Helen Suzman Foundation reportedly warned that the white paper "fails to make a clear choice" between suppressing the private sector and "intelligent cooperation with it".
The Independent Municipal and Trade Union reportedly said it would be better if medical aids were left in place in case the NHI fails to work. It also submitted that some aspects of the NHI might be unconstitutional, such as the fact that patients will only be able to use doctors accredited by the NHI.