Health Minister Dr Aaron Motsoaledi. Picture: Gallo Images/Frennie Shivambu
Minister of Health Dr Aaron Motsoaledi has rubbished claims of a National Health Insurance (NHI) compromise that would see everyone employed in the formal sector forced to join a medical aid scheme, saying there is no plan to do that and that it is unfounded and ridiculous.
According to an article in Rapport on the weekend, the ANC plans to table a compromise proposal at the first Cabinet lekgotla of 2025 that all South Africans working in the formal sector must be obliged to obtain medical coverage.
In addition, the state will compete with medical schemes to provide cheaper medical insurance through the NHI.
Unemployed people – or people who cannot afford to join a medical aid scheme – would still be helped at state hospitals.
According to the publication, the ANC wants to table the proposal because it hopes to appease its DA partners in the Government of National Unity (GNU) after a heated cabinet meeting in October.
Motsoaledi wanted to add NHI to government’s medium-term development plan, which sets the GNU’s priorities for the next five years. The DA objected because it would have destroyed medical aid schemes by 2029.
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The minister issued a press statement to say that he and the department of health want to place on record that there is no such proposal that will be tabled and that the “allegations are both unfounded and ridiculous”.
Motsoaledi said there is no such plan from the ANC or government and that it is a figment of the imagination of either the author of the article or his unknown sources.
“The heading of the article claims that the ANC is going to force medical aid schemes to be cheaper. It is now an uncontested fact that private health care costs are escalating at a rate that are likely to collapse the sector.
“Medical aid schemes recently increased their subscriptions by up to 10% and more, with GEMS increasing by 13%.
“However, even people with rudimentary knowledge of private health care will know that forcing medical aids to be cheaper is not a solution to this problem. In fact, it will be dumb for anyone to suggest that,” the minister added.
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He said he finds it surprising that “certain segments of the media” keep second-guessing what will be done with the costs of the private health sector.
This despite the fact that a comprehensive market inquiry chaired by an eminent jurist, retired Chief Justice Sandile Ngcobo, conducted a six-year deep investigation into this matter to avoid anecdotes and snake-oil remedies as suggested by this article.
“Justice Ngcobo received evidence and research from many domestic and international experts, including many from South Africa’s private sector. It is very disappointing that people who want to write about this matter are still going on a wild goose chase.”
Motsoaledi is referring to the Competition Commission’s Health Market Inquiry Report that was chaired by Justice Ngcobo, released in 2019.
According to the report, the commission established that private healthcare is characterised by high and rising costs, significant over-utilisation and no documented improvement in health outcomes.
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The minister promises that he will call a press conference in the coming weeks to elaborate on the way forward with the recommendations of the Health Market Inquiry.
“The department of health is worried that there is persistent and consistent disinformation about NHI. We know that the media widely publicised that NHI will cost R1.3 trillion (presently the total budget for the country).
“In recent days there is a claim that each taxpayer will pay R37 000 extra in tax because of NHI. This despite that, because the matter is in court, the minister responded in a 215-page affidavit under oath, with sixty pages dedicated to this cost issue of NHI.”
Motsoaledi said the Health Market Inquiry, as well as his affidavit, are in the public domain.
“One would have expected that anyone in the media who wants to make comments on these matters, would have at least looked at these publicly available documents.
“The department is perturbed by the posture of the media in respect of NHI.
“While we consider the media’s sacrosanct role and mandate as that of informing and educating the public, recent reporting on NHI represents nothing but an onslaught by some sections of the media on NHI – which clearly is aimed at adding confusion and discrediting NHI in the eyes of the public.”
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Dr Richard Friedland, CEO of Netcare, proposed in September last year at the Hospital Association’s congress that requiring everyone in formal employment to be members of a medical aid scheme was a way to help address the country’s health crisis.
He said the ANC already recommended this in its 1994 Health Plan and that in 1997, the National Department of Health Social Health Insurance Working Group recommended mandatory cover for formal sector employees for people who earn above the income tax threshold, due to affordability concerns.
Friedland said one of the benefits of mandatory medical cover for the formally employed population would be an increase in public health per capita spend, which could increase by 52% without any additional funding from the public sector budget.
“The latest per capita public expenditure based on a consolidated health budget of R271 billion works out to R5 054, when considering the population and excluding medical scheme users.
“With formal employment coverage, that per capita public expenditure on public health users would increase by 52% to R7 659, research shows.”
Trade union Solidarity also made a similar proposal last year as an alternative to NHI, saying that all people in formal employment must be required to join a medical scheme of their choice, while the unemployed continue to be served by the public healthcare system.
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