The gap between private and public healthcare in the country is among the biggest in the world. With a recent study by the Organisation for Economic Co-operation and Development (OECD) indicating that private hospital prices in South Africa are around the levels observed in countries with much higher GDP levels, such as France, Germany or the United Kingdom.
Only 20% of South Africans enjoy quality healthcare while the high costs in the private sector mean that the vast majority of the country’s population is forced towards the already overwhelmed public sector, says Get Health co-founder and CEO, Trevor Brewer.
Brewer, together with his business partner, Gary Hill, have sought to tackle the imposing healthcare sector in South Africa by making private sector quality healthcare more accessible to the country’s majority.
“Starting any business is very daunting no matter what the industry but the healthcare sector certainly has its specific challenges,” says Brewer.
“It was obvious that the system has fundamental challenges,” Brewer says, “The public sector is over-burdened with demand due to lack of affordability of the private sector to the majority of the population. Public providers are forced to see hundreds of patients a day often resulting in decreased patient satisfaction and quality. Something needed to be done as the over-priced private sector is making high profits serving the top 20% of the population so there is no desire to try serve lower economic groups.”
Quality healthcare for the majority
Get Health aims to offer services that are similar to that of a private GP, but much more affordable, according to Brewer. This is made possible by their business model which takes a different perspective on managing a social enterprise.
The clinic operates on a fee-for-service model. Patients are first assessed by health coaches from the local community, before they are forwarded through to Get Health’s healthcare professionals. Consultation prices start from R165-R200 and cover everything from everyday ailments to chronic and lifestyle disease management.
SME South Africa speaks with Trevor Brewer about how they are dealing with the complex healthcare system and why they see their model becoming successful in South Africa.
Why the business model is suited for South Africa
The business model is built off the core vision of providing access to high quality primary healthcare at an affordable price. This is done using our unique delivery model through our growing network of clinics, on a fee for service basis. Local entrepreneurs are recruited to ensure equitable access to high quality healthcare.
The South African population deserves the right to choice and by Get Health entering the healthcare market, we are giving the customer that. Currently there is limited choice for customers seeking higher quality healthcare at an affordable price. Get Health provides this and by staying patient-centric we hope to grow the business across the country, serving millions of people every year.
Balancing the social and the profit motives
Get Health is certainly a social enterprise, but first and foremost we are a business. We need to run at a profit to ensure sustainability as well as give us the opportunity to scale. It is only through scale and sustainability that our mission can be delivered. Profit motive is not mutually exclusive of being socially focused and the two can work hand in hand.
Capturing the lion’s share of the market
The Get Health target market includes families and individuals categorised in LSM 4 to LSM 8 groups. This population includes approximately 23 million South Africans. LSM groups 9 and 10 are well served with healthcare through a combination of private hospitals and medical insurance. The middle and lower LSM groups remain underserved in terms of choice of healthcare as well as accessibility to quality healthcare.
The sector’s complex barriers to entry
The healthcare sector in South Africa is certainly very complex with high barriers to entry. This complexity comes in the form of strict regulations and regulatory bodies.
We spent a large amount of time learning about the environment and seeing how best we can transverse the landscape. Unfortunately this learning came in the form of high legal fees, which perpetuates the high barriers to entry.
We have however found that, for our target market, there are not as many barriers as one would expect which creates a great environment to foster competition. We are big believers in competition as through competition the South African public will benefit due to decreased costs and higher quality.
The massive problem we are solving
Unfortunately the barriers to accessing healthcare are so high in South Africa that many people only wait until they are very sick to access healthcare. This is due to the high private healthcare costs as well as the long queues and ineffective healthcare at some public facilities due to the overburdened demand.
These high barriers result in South Africans being very curative in nature as opposed to preventative. As such, healthcare costs are expensive due to high hospital admissions. We want to be part of the solution by decreasing the demand on the public sector by drawing those who can afford something into our facility as well as focusing on preventative healthcare to keep people out of hospital.
“Get Health is certainly a social enterprise but first and foremost we are a business”
Keeping up with international trends
Our model was built off what we thought were best practises that came from countries like the USA, India, Cuba and Kenya. Although the US may be seen as the last place to find affordable high quality care, it is due to their high costs that innovation is taking place.
This innovation came in the form of a new type of healthcare worker, which focuses on the patient experience and empowerment through educating the patient. In India and Kenya, they have been providing healthcare to lower income earners for a long time so great learning came from patient behaviour within these countries. Additionally healthcare offerings and innovative financing models were adapted from these countries.
Premium quality vs affordability
Unfortunately, quality and affordability were often seen as an oxymoron and therefore a new delivery model needed to be developed. Once this model was developed the main challenge came in the form of recruiting the right people into the business.
People are the most important component of a service business and as an entrepreneur it is hard to find people who share the same vision and mission as you do. This is where we discovered the importance of having a purpose.
People will buy into a purpose more than a job or constant salary. Through our recruitment process, which involves the youth development agency Harambe, we are able to identify individuals on certain characteristic and then sharing our purpose and reinforcing it everyday in all our actions and dealings with staff.
The strategy for growing the business
The clinic in the Johannesburg CBD was a great pilot project, which enabled us to fully define who our ideal patient is. We were situated in a mixing pot of social demographics as within a 2km radius we had people living in hijacked buildings, employees of FNB Bank City as well as everyone in between.
Due to our key learnings, we are in the process of moving that site closer to where people live. As increasing accessibility is at the heart of Get Health’s mission we need to ensure we are situated close to where people live. We have developed a new model, which will use a co-ownership model by empowering local entrepreneurs within the community a clinic serves to owner/manage the clinic.
Full ownership will be passed over to the local entrepreneurs once they hit certain financial and quality metrics. Within the service industry it is shown that productivity and quality levels are much higher when the manager has vested interests in the businesses’s success.
