In a country where access to quality healthcare remains a stark divide, Dr. Reinder Nauta, founder of the National Health Care Group, is pioneering a model that aims to bridge the gap left by high-cost medical aids and the overburdened public sector. His initiative, detailed in a recent interview, offers a pragmatic and technologically savvy alternative to South Africa’s urgent healthcare needs, particularly for the vast majority of citizens without medical aid.
The Genesis of a Low-Cost Model
Dr. Nauta’s journey into low-cost healthcare is rooted in a deep understanding of South Africa’s socioeconomic realities and a relentless work ethic. A medical degree was financed largely through debt, bursaries, and intense periods of ‘locum’ work as a Senior House Officer in the UK’s National Health Service (NHS). Complementing this was an entrepreneurial spirit honed through years of working in a Shoprite supermarket, from ‘picker’ to ‘checkout supervisor’. It was here he learned a crucial business lesson: “complaining customers are the most valuable customers”.
The impetus for his mission crystallised during his time at Red Cross Children’s Hospital in the “dawn of the new South Africa”. Following President Nelson Mandela’s announcement of free healthcare for children under six, the hospital was overwhelmed, with doctors seeing up to 120 patients a day. This experience convinced Dr. Nauta that no government institution could cope alone, necessitating the private sector to “come to the party”.
This led to his first venture, K Cross Health, which he eventually sold to a large insurance company after 15 years. The company successfully pioneered a ‘shared risk’ model with General Practitioners (GPs) – a fee-per-member-per-month system – and created the first branded network of doctors, bringing an estimated 350,000 people into the medical aid system.
However, the costs, around R400 to R500 per person per month for primary care, were still too high to reach the base of the socioeconomic pyramid. This realisation, coupled with the inspiration drawn from reading Helen Zille’s book, Not Without a Fight, prompted him to launch his current venture with the aim of achieving a price point closer to R200 per person per month.
Technology and Efficiency: The R200 Solution
The key to achieving this dramatic cost reduction is the integration of technology, specifically the ubiquitous platform of WhatsApp. This is the first point of access for all clients and is linked only to their ID number, allowing them to use any phone. A nursing triage panel manages initial queries, offers advice, sends electronic prescriptions, and only refers the patient to one of the 3,000 network GPs when more help is needed.
This gatekeeping process, which manages “time consuming and expensive” initial consultations, is crucial to preventing runaway costs. The GP is still paid a normal low-income consultation fee of about R500, but the model works by controlling the volume and necessity of in-person visits.
The National Health Care Group’s products are registered insurance products that offer basic primary care, including access to a GP, any pharmacy in South Africa, some X-rays, and blood tests, with slightly more expensive options adding radiology, dentistry, optometry, and chronic medication.
The Sustainable Free Market Approach
The venture is backed by major investors, including African Rainbow Capital (founded by Patrice Motsepe). Dr. Nauta insists that Non-Governmental Organisation (NGO) models are unsustainable in the long run, as they eventually lose their prime sponsors, preferring a free market approach where profitable businesses are the ones that are sustainable.
Ultimately, the new model is designed to appeal to corporates, particularly those with a high number of lower-income employees – such as restaurants, guesthouses, and tourism operations – by addressing problems with absenteeism and sick note fraud and boosting employee morale for a nominal cost. By providing access to the private sector for employed people, the system also benefits the unemployed, who will then have better access to state facilities.
The National Health Care Group is now in its scaling-up phase. Dr. Nauta believes, this model, which he was inspired to pursue after meeting Mother Teresa earlier in his career , is one that will revolutionise primary healthcare access in South Africa.
