Can you imagine being booked for a crucial operation, only for your medical aid to then say you have to go to a different hospital or fork out an additional R5000? Well, this is the situation a number of Discovery health members find themselves in.
Kieno Kammies speaks to Dr Ryan Noach Deputy Chief Executive at Discovery Health and a doctor, Dr K who says his patients are suffering because of these last minute changes, only communicated to doctors and patients on 1 January 2019.
Discovery health has changed a number of hospital procedures from the big general hospital facilities to day hospitals, something it argues is far more cost-effective and sustainable in the face of increasing medical costs for patients.
Patients are booked into daycare hospitals and discharged the same day they undergo surgery.
Patients are paying good money to the medical aid plans...with procedures booked in December for January...and they suddenly get hit by an R5000 co-payment because the hospital the patient is booked it is not on this initially mythical list of approved hospitals.— Dr K, medical practitioner Cape Town
He says the first he heard of this was when his patients began cancelling arranged operations this past week.
He says having an operation is very stressful for patients and this additional stress is most unwelcome.
It's a good plan, but the infrastructure in Cape Town is not good enough.— Dr K, medical practitioner Cape Town
He also took issue with the fact that some big hospitals remained on the list and others had been removed.
Dr Noach responds to these concerns and explains Discovery's thinking behind the shift in line with an international move to make medical care more affordable and sustainable.
He explains that the big hospitals on the list have created special in-house daycare facilities which fit the criteria.
Day hospitals also have less 'superbugs', he says and can, in fact, be safer than big hospitals that struggle to contain nosocomial infections.
He says it is a defined list of procedures recognised the world over as able to be conducted in day hospitals.
Noach says hospital groups took a long time to finalise their decisions with regard to the changes, hence the late notice.
He insists that operations already booked for January will still be allowed to go ahead at the pre-booked facilities and co-payments will not be enforced.
Listen below to the discussion: