'I feel imprisoned by medical aids'

02 August 2019 - 09:24
By Yoliswa Sobuwa
The revelation by the general practitioner, who asked not to be identified, came after he was blacklisted by banks.
Image: 123rf.com/Dmitriy Shironosov The revelation by the general practitioner, who asked not to be identified, came after he was blacklisted by banks.

A medical doctor has shared how being sidelined by medical aid schemes almost drove him to commit suicide.

The revelation by the general practitioner, who asked not to be identified, came after he was blacklisted by banks and also had his car repossessed.

His story was among submissions made by Solution Thinkers, a group of practitioners, who made their presentation to the Council on Medical Aid Schemes which is holding hearings into allegations of racial profiling against black and Indian private medical practitioners.

The council called the Section 59 investigation panel following allegations by medical practitioners and members of the National Health Care Professionals Association that they were being unfairly treated and their claims withheld by medical aid schemes based on the colour of their skin and ethnicity.

The doctor, known to Sowetan, told the council that he bought his practice last year, but he has already tried killing himself twice.

"I feel imprisoned by medical aid schemes and as things stand now, my 14-year-old girl has been told to stay away from school as we are behind with her school fees.

"My 18-year-old daughter will not attend her matric dance, because I can't afford to buy her a dress," he said.

Phonyoka Seeco, 60, a medical practitioner from North West, said she had to take her children out of school as her practice has been operating on "reserves".

"I have been servicing members of the public for seven years without payments. I complained to the council but nothing has been done," she said.

The doctors also complained that medical aid schemes demanded proof of consultation, including clinical notes, while their white counterparts were just required to verify a consultation before payments were made.

During the presentation on behalf of Solution Thinkers, Dr Tabeho Mmethi said medical aids want to own the whole supply chain in the healthcare industry.

"They are highly anti-competitive and they destroy market entrants and their funds do not last forever. We are not supporting fraud, but the system disadvantages ethical practices," Mmethi said.

The doctors recommended that all extorted money be refunded with interest and that racial profiling should be severely punished for.

"The dignity of the healthcare practitioners should be restored and medical aid benefits should be structured to favour patients and be sufficient for the whole year," the Solution Thinkers submitted.

Yesterday, the South African Medical Association made their presentation, saying "the services are rendered, firstly, upon a declaration by the member concerned that he is a fully paid-up member of a medical scheme and, secondly, an authorisation by provider itself [via its administrators] that the services may be provided and will be paid for by scheme".