The proposed National Health Insurance (NHI) will offer all South Africans and legal residents access to a defined package of comprehensive health services and it is committed to offering a wide range of services as possible.
This is according to health minister Dr Aaron Motsoaledi, who said the NHI is a health financing system that pools funds to provide access to quality health services for all South Africans based on their health needs and irrespective of their socio-economic status.
He also stressed that a massive reorganisation of the current health system, both public and private will be needed for the planned NHI system to work.
This health insurance will cover every South African, employed or unemployed, earning a low income or high income.
The minister said the service offering will range from primary healthcare to specialised tertiary and quaternary levels of care, and patients will not be told that their benefits have run out or be asked to share the costs of treatment unless they fail to follow the required referral route.
Motsoaledi said the national health insurance will be run as a non-profit public entity and will strengthen the hand of the healthcare consumer.
Proposed operations of the the NHI:
- Employers will assist the NHI fund by ensuring that their workers’ NHI contributions are collected and submitted, in a manner similar to UIF contributions.
- The NHI will not manage hospitals, clinics or the practices of GPs, dentists, specialists and other health professionals.
- NHI will enter into contracts with private and public hospitals, as well as private health practitioners and public clinic, to provide services. A patient will be able to choose any NHI-contracted provider near to him or her for regular health needs.
- Individuals will be free to continue their medical scheme membership, but they will not be able to opt out of making contributions to the NHI fund.
- The NHI fund will get a large amount from general taxes, while people with low income will not make any direct payment to the NHI fund. Those earning above a set amount will be required by law to contribute.
Points of interest
- NHI is designed to create a single compulsory medical scheme for all.
- An additional amount of R4.2 billion in the current national budget has been allocated to the NHI.
- All citizens and permanent residents will be covered by the NHI, while a special fund will be set up for refugees.
- Documented asylum seekers will be able to access emergency care.
- The NHI will be introduced in three phases. The first phase is preparing central hospitals to provide specialised services to all citizens, under the control of central government. In phase two, all those who qualify for NHI will be registered and given NHI cards. In the third phase, working people will start to make mandatory payments and private sector providers such as hospitals and specialists, will be contracted to provide services.
- The National Health Insurance Bill was approved by cabinet in 2017 and the targeted date for implementation of the NHI is 2025.
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