Inquiry finds medical schemes guilty of racial discrimination

Stephen Grootes speaks to Thoneshan Naidoo, Health Funders Association CEO, about the findings of the Section 59 inquiry, which revealed that three top medical aid schemes are guilty of racial discrimination against black medical practitioners.

Listen to the interview in the audio player below.

Three leading medical schemes have been found to have acted unfairly by utilising racially discriminatory practices towards black doctors and healthcare providers.

The findings were revealed following a Section 59 inquiry by an independent panel commissioned by the Council for Medical Schemes into the practices of medical schemes.

The panel which was chaired by Advocate Tembeka Ngcukaitobi found that Discovery, the Government Employees Medical Scheme (Gems) and Medscheme were guilty of the racially-based practices.

It found that claims submitted by patients who had black doctors or healthcare providers had a higher chance of being investigated, compared to patients with white doctors.

As a result, many healthcare workers or patients had to wait longer for patients, or were not even paid out at all.

According to the findings, Medscheme was six times more likely to investigate a claim from a black anesthetist than a white one, while black dental therapists were three times more likely to be investigated. 

Speaking to Stephen Grootes on The Money Show, Thoneshan Naidoo, CEO of the Health Funders Association however rejected the report.

"I do not believe there is racial profiling, and in fact the report actually said so, that it isn't actually the case. And in fact, it went further to say, they didn't find any cases...."

- Thoneshan Naidoo, CEO - Health Funders Association

"Over 90% of providers are paid without any issue. Less that 10% of providers are flagged...and there's a wide spectrum of that 10%."

- Thoneshan Naidoo, CEO - Health Funders Association

"...majority of it are billing errors. When we talk about billing errors, we're talking about billing for 10 litres of oxygen, which could be a typo when it's supposed to be for 1 litre."

- Thoneshan Naidoo, CEO - Health Funders Association

Scroll to the top of the article to listen to the full interview.