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Medical aid inquiry told GPs earned smallest share in funds collected by schemes

NHCPA chair Dr Donald Gumede said medical aid scheme executives, like Discovery Health, rewarded themselves for withholding payments intended for doctors.

Picture: pexels.com

CENTURION - The National Health Care Professionals Association (NHCPA) said medical aid schemes were becoming cash cows at the expense of general practitioners (GPs) who were at the centre of the profession.

On Wednesday, the association presented to the Section 59 inquiry into allegations of racial profiling by medical schemes.

It told Advocate Tembeka Ngcukaitobi and his panel that schemes were becoming prosecutors and judges in their own cases when they decided to blacklist professionals.

NHCPA chair Dr Donald Gumede said GPs earned the smallest share of the medical aid funding collected by schemes.

“Thirty-five percent of the money goes to administrators, 40% to hospitals which are partly owned by medical schemes, 20% goes to specialists, such as pharmacists, and 5% went to GPs who are actually at the heart of mistreatments.”

He said medical aid scheme executives, like Discovery Health, rewarded themselves for withholding payments intended for doctors.

“Seven directors would share R15 million, a pool of 1,134 managers will share R265 million, 203 people will share R85 million and CEO of Discovery was paid R12 million in bonus.”

The association said medical schemes were illegally forcing doctors to acknowledge fraud and debt before they could be paid.

SCHEMES MUST PAY BACK WITHHELD MONEY

The NHCPA wanted medical aid schemes to pay back all the money that has been withheld from practitioners and patients over the years.

It also wanted the council for medical schemes to be suspended.

The association said schemes committed the biggest corporate fraud and The Council for Medical Schemes aided and abetted them

The NHCPA’s Thandi Mkhize Mavimba said the Council for Medical Schemes should be held responsible for doing nothing as practitioners and patients were defrauded.

The association said schemes should have reported fraudulent doctors to law enforcement but instead they decided to make them sign acknowledgements of fraud and debt while they cashed in.

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