| Summary: | M.Comm. === Health care is recognised as a basic human right. The current position of private health care in South Africa is of great concern. Not only is health care almost unaffordable but the future quality of health care also causes great concern. With this in mind it is obvious that alternatives to conventional medical aids and health insurance are necessary to guarantee the continued availability of quality medical care to the South African public. Most people would agree that our private sector health care system is characterised by a depressing history of inadequate planning, control and management. It is for this reason that amendments to the Medical Schemes Act were considered necessary. Certain of these amendments will extend the role played by medical schemes in the management of health care resources. This will result in the traditional boundaries and relationships between the public, health professionals and health care facilities, and the financiers in our private health care system being altered. A new philosophy will evolve based on open and participative practices, as well as increased coordination, integration and cooperation (Veliotes et al, 1993: 12). Internationally, the health care objectives of most countries are to provide access to highquality care for all the people, and to provide this care efficiently and effectively. In the last decade the task of achieving these potentially conflicting objectives has become more difficult. At present, private health care is funded by medical schemes, health insurance companies, employers and individuals themselves. Neither medical aids nor health insurance companies are able to contain the rise in health care cost, which has led to the emergence of a new method of finding, namely Managed Health Care (MHC). Health care cost has accelerated at a rate far above the consumer price index(CPI). Rising health care costs in the private sector have been blamed on structural inefficiencies in the medical aid system. While patients have little incentive to minimise care expenditure, providers have an incentive to overuse the system.
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