THE South African Institute of Race Relations (IRR) says that while government is busily pressing ahead with implementing its proposed National Health Insurance (NHI) system it still does not know what the NHI will cost, how it will be financed, how the supply of health services can be ramped up to match increased demand, how the enormous administrative burden will be met or how the corruption the new system will foster can be curbed.
According to Dr Anthea Jeffery, Head of Policy Research, the revised White Paper on the NHI which was gazetted by the health minister, Dr Aaron Motsoaledi, on 30th June 2017, does nothing to tackle the many weaknesses in earlier NHI proposals.
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“The White Paper largely ignores the problems of poor management and often poor quality in the public healthcare sector. Instead, its key concern is to put an end to the medical schemes that currently give close on 9 million people (some 60% of them black) access to the benefits of the country’s world-class system of private health care. Government regulation has already pushed up the cost of medical schemes to the point where many people battle to afford them. The state has also refused to allow a low-cost option that would extend cover to at least 15 million more South Africans,” said Jeffery.
According to Dr Motsoaledi, all medical schemes will “eventually be gone”, once the NHI is in operation. “This will be a process that takes years and, in the transition, there will be consolidation,” he says. Once the NHI has been rolled out, the medical schemes that remain will “all be collapsed into a single state-run medical aid plan”, he stresses.
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Public servants are becoming worried about this goal, said Reuben Maleka, a spokesman for the Public Servants’ Association.”Members would prefer medical aids. We don’t want to find ourselves in a situation where the NHI is the only option.”
“The government has generally ignored these practical alternatives. Instead, Dr Motsoaledi has repeatedly accused critics of the NHI of wanting to retain an unfair system and deprive South Africans of the benefits of universal health coverage (UHC). Critics are not opposed to universal health coverage, but rather to the inability of the NHI to achieve it,” concluded Jeffery.
