12/08/2019 National Health Insurance Talking Points

“[South Africa faces] serious challenges mainly caused by a skewed healthcare financing system. Without NHI, the burden of disease in the country will not be reduced because the majority of the population – and the section suffering the greatest ill health – will not access good quality healthcare.” – Zweli Mkhize, Minister of Health

The National Health Insurance (NHI) Bill has officially been introduced to Parliament, and could be law by July next year. The intentions are good, but the question is – can we pull it off? Here’s a quick summary of the talking points currently doing the rounds. Follow the links for more information.

The hopes
• To provide free healthcare to all South Africans.
• To give everyone equal access to healthcare, regardless of race, gender, location or socio-economic status. “There are currently over 4 000 public health facilities that service over 80% of the population’s primary healthcare needs,” writes Wits’ Russell Rensburg. “In the private sector there are close to 5 000 general practitioners who service the healthcare needs of only 16% of the population. And most are concentrated in urban areas.”
• To correct the current lack of funding in the public healthcare sector. All healthcare funding will be consolidated in one pool, where currently the private sector is receiving most of the money on behalf of few of the people.
• To optimise healthcare spending. The thinking is that as a single purchaser, the NHI will have the power to “determine the most appropriate, efficient and effective mechanisms for drawing on existing healthcare service providers.”

 
The fears
• The cost of the proposed NHI is projected to be staggering, estimated to top R350 billion. This will put a serious tax burden on middle-income earners.
• The DA’s objections to the NHI include fears that it may eradicate medical aids. For example, medical aids will not be allowed to cover any health services offered by the NHI. Read an in-depth analysis here.
• There are fears the NHI will interfere with access to private healthcare services. For example, it is proposed that patients can only see a specialist if referred by an NHI doctor, or the service won’t be covered. In turn, it’s feared that this may threaten the sustainability of private providers.
• There’s already a shortage of public medical staff, who will now face a greatly increased workload.
• The R4.9 billion pilot project was reportedly not a success, reportedly “so poorly conceived that the health department cannot say what worked and what didn’t.” Meanwhile, the failure of other state-run entities such as Eskom raises doubts about Government’s ability to administer the project.
The Bill may have been tabled but the debate is likely to continue for the foreseeable future. Watch this space.

Take a look at some of the media coverage of the National Health Insurance Bill:

  1. Five things you need to know about the new National Health Insurance Bill
  2. ANALYSIS: The National Health Insurance – What it means and the fights we can expect
  3. ‘Govt’s NHI will kill the private health sector’, says DA as it presents Sizani

Until next time, take care.

Jacques

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