The South African Medical Association (SAMA) recommended that Section 59 inquiry investigating racial profiling should overhaul the benefits model of medical schemes in the country.
The association made representations at the inquiry in Centurion on Thursday.
Dr Norman Mabasa said because of that model, hospitals and specialists only wanted to attend to patients with limitless funds.
SAMA said it didn’t make sense that medical schemes wanted to investigate general practitioners for fraud when they only earned R6 billion annually compared to specialists who earned more than R20 billion.
Mabasa said specialists and hospitals colluded in their preference for patients who had unlimited benefits.
“The specialists have the privilege of seeing patients as many times as they want and claim for it.”
He said the panel must recommend an overhaul of the whole benefits system.
“…That benefit design be looked at as well because we now admit unnecessarily because outside the benefits are exhausted you can only be paid for fully if you are at the hospital.”
The independent practitioner’s association also made representations.
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