The challenges of standardization of pricing in private healthcare in South Africa

Abstract

The aim of the study is to analyse the challenges faced by different stakeholders in the standardisation of prices in private healthcare in South Africa. The definition of pricing is discussed, and the pricing models used by both the public service and the private healthcare sector are explored and compared. Different legislation applicable to healthcare is analysed, including the envisaged National Health Insurance. The study looks at how medical schemes have found a way of controlling pricing through legal concepts designed by the government, concepts such as the Designated Service Providers and Managed Care Protocols. Future plans aimed at reaching consensus in the setting of prices is also discussed, including the government’s Discussion Document: The Determination of Pricing in the Private Sector. The study also looks at how the courts have become the role players in the arguments about the pricing of private healthcare. Each chapter is set on its own topic that deals with a specific section of the topic. There is an introduction to each chapter, ending with a relevant conclusion at the end. Where Abbreviations were used, the abbreviation is usually preceded by the full meaning of the letters in order to reduce the size of the document.