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The Healthcare System in South Africa

The healthcare system in South Africa can be defined according to two sectors, namely public and private. The private sector is growing, but still significantly smaller than the public sector.

The private sector caters to around 7 million- mostly higher net worth people, leaving the public sector to cater for the rest. Ironically, the public sector actually spends less each year than the private sector even though it provides healthcare services to the majority of the population.
Statutory bodies such as The Health Professions Council of South Africa are on a constant mission to monitor and improve the standard of healthcare in South Africa.

The health professions council was founded to provide guidance to medical professionals as well as monitor, regulate and improve the practice of healthcare in South Africa. This is achieved by setting and maintaining standards with regard to professional conduct, training and education, safety and ethical behaviour.

The HPCSA caters to the public and private sector. It provides a development system that offers seminars and workshops to medical professionals to maintain and improve the quality of the services they render. Members pay for these workshops through an annual membership fee.
The council consists of 12 professional boards. Each board is responsible for managing and implementing the procedures relating to that particular area of medical practice. The 12 boards are categorized according to medical field and are as follows:

1) Dental Therapy and Oral Hygiene
2) Dietetics
3) Emergency Care
4) Environmental Health
5) Medical and Dental, (and medical science)
6) Medical Technology
7) Occupational Therapy, Medical Orthotics / Prosthectics and Arts Theory
8) Optometry and Dispensing Opticians
9) Physiotherapy, Podiatry and Biokinetics
10) Psychology and Clinical Technology
11) Speech, Language and Hearing Professions
12) Radiography and Clinical Technology

The HPCSA follows a regulatory framework that includes the founding Health Professions Act 56 of 1974. The framework defines the scope of each profession and outlines the procedures to be followed by the HPCSA in monitoring the activities of healthcare practitioners.
Registration with the HPCSA is required to legally practice in any of the 12 fields of specialization. The registration process varies between the different professional boards. Once registered, it is also the responsibility of the involved parties to provide as accurate and up to date information as possible.

The healthcare professions council also serves to reinforce safety because the likelihood of accidents as a result of fraud or under-qualified practitioners is greatly reduced. Organizations specializing in healthcare accreditation focus on developing systems and processes to continually improve the standard of healthcare across the board.

What To Expect From An ACO Healthcare System

ACO healthcare is a hot topic in medical and health provider circles. Many states have considered shifting to the ACO system and it is causing concerns among some people and organizations. Some feedbacks are positive while others are not. ACO is an acronym for Accountability Care Organization.

In an Accountability Care Organization system, you will have to coordinate all your medical and healthcare needs with a primary physician. So, if you need to see a heart specialist and if your primary doctor does not specialize in that fields, then your primary physician will provide you with an accredited doctor who treats heart problems.

Your primary doctor will monitor your case and coordinate with the heart specialist he recommended to you. Your primary doctor may use an HL7 Interface to coordinate with other doctors handling your case. You will get all the diagnostic tests and get confined at a hospital if necessary under the same ACO healthcare program. Patients can get all the medical care they need under one umbrella.

If you choose to see your doctor who is that connected to the ACO system, you will have to pay more for consultation, diagnostic tests, confinement and doctor’s fees. Some people like the system that involves an overseer which is your primary doctor. Others don’t like the thought of being limited to their choice of physicians and specialists.

Some physicians are open to the idea, while others are a little wary about implementing or joining an ACO system. There are physicians who prefer to work with a team and others who find it cumbersome. Some health care experts fear that it might not be possible to have a single healthcare system that can offer everything patients need.

An ACO healthcare system is similar to the way an HL7 interface works wherein medical professionals and healthcare people can share, integrate and manage a patient’s healthcare program. An HL7 system makes it possible for physicians to retrieve data, medical information, and evaluations of a patient through an electronic health database.

With the present healthcare system that is implemented by Medicare and other health insurance companies, doctors get more financial compensation for providing more service to patients. Hospitals will also make more money by encouraging patients to check into the hospital, even more minor procedures that can be treated as an out-patient basis.

Even laboratories make earn more by running unnecessary tests and calling them procedural tests. An ACO healthcare system on the other hand will provide more pay to doctors and medical facilities if they are able to lower costs yet meet quality service and treatment for patients. In other words, the income of doctors and hospitals will increase if they are able to improve quality of care for the patient.

Their pay does not necessarily increase if they garner more patients or ask patients to undergo more tests and medical procedures. If a hospital or physician fails to meet standards for quality of care and cost-cutting measures, they will get less money from healthcare insurers and Medicare. Physicians will be awarded for providing better healthcare to patients.